Clinical and electrophysiological predictors of device-detected new-onset atrial fibrillation during 3 years after cardiac surgery
Creators
- 1. 1Department of Cardiothoracic Surgery, Maastricht University Medical Centre, P. Debyelaan 25, POB 5800, 6202 AZMaastricht, The Netherlands; 2Department of Physiology, Maastricht University, The Netherlands; 3Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands;
- 2. 2Department of Physiology, Maastricht University, The Netherlands; 3Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands;
- 3. 2Department of Physiology, Maastricht University, The Netherlands
- 4. 4Department of Cardiothoracic Surgery, Amphia Hospital, Breda, The Netherlands
- 5. Department of Cardiology, University of Groningen,University Medical Centre Groningen, Groningen, The Netherlands; and 6Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
- 6. Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands; and Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
Description
Postoperative atrial fibrillation (POAF) after cardiac surgery is an independent predictor of stroke and mortality
late after discharge. We aimed to determine the burden and predictors of early (up to 5th postoperative day) and
late (after 5th postoperative day) new-onset atrial fibrillation (AF) using implantable loop recorders (ILRs) in
patients undergoing open chest cardiac surgery
Seventy-nine patients without a history of AF undergoing cardiac surgery underwent peri-operative high-resolution
mapping of electrically induced AF and were followed 36 months after surgery using an ILR (Reveal XTTM). Clinical
and electrophysiological predictors of late POAF were assessed. POAF occurred in 46 patients (58%), with early
POAF detected in 27 (34%) and late POAF in 37 patients (47%). Late POAF episodes were short-lasting (mostly
between 2 min and 6 h) and showed a circadian rhythm pattern with a peak of episode initiation during daytime. In
POAF patients, electrically induced AF showed more complex propagation patterns than in patients without
POAF. Early POAF, right atrial (RA) volume, prolonged PR time, and advanced age were independent predictors of
late POAF.
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