Abstract
Atrial fibrillation remains the commonest arrhythmia encountered in cardiac surgery. Data on the effect of preoperative atrial fibrillation on postoperative outcome remain limited. We sought to assess the effects preoperative atrial fibrillation on patients' outcome following cardiac surgery. This is a retrospective review of prospectively collected departmental data of all patients who underwent cardiac surgery over 8-year period. Our cohort consisted of 3777 consecutive patients divided into atrial fibrillation (n = 413, 11%) and sinus rhythm (n = 3364, 89%). Postoperative complications and in-hospital mortality were analysed. Univariate analysis showed significantly increased mortality and major complications in atrial fibrillation compared to sinus rhythm patients. Using multiple logistic regression analysis and after accounting for Euro SCORE as a confounding variable, we found that preoperative atrial fibrillation significantly increases the risk of mortality (OR 1.7), low cardiac output state (OR 1.3), prolonged ventilation (OR 1.4), infective complication (OR 1.5), gastrointestinal complications (OR 2.0), and intensive care unit readmission (OR 1.6). Preoperative atrial fibrillation in cardiac surgery patients increases their risk of mortality and major complications following cardiac surgery. Surgical strategies such as Cox-Maze procedure may be beneficial in these patients.
Highlights
Atrial fibrillation (A Fib) is the most common arrhythmia seen in cardiac surgery
Using multiple logistic regression analysis and after accounting for Euro SCORE as a confounding variable, we found that preoperative atrial fibrillation significantly increases the risk of mortality, low cardiac output state, prolonged ventilation, infective complication, gastrointestinal complications, and intensive care unit readmission
Advancing age has been shown to have a significant association with the incidence of A Fib, a relationship that is important as the number of elderly patients referred for surgical revascularization is increasing [2]
Summary
Atrial fibrillation (A Fib) is the most common arrhythmia seen in cardiac surgery. It has been identified in nonsurgical patients as a marker of severe cardiac disease and a risk factor for decreased long-term survival [1]. Previous studies have examined the effects of preoperative A Fib on mortality following cardiac surgery, the full spectrum of postoperative complications that might be encountered in such patients has not been reported. We sought to assess the effect of preoperative A Fib on postoperative outcome in patients undergoing cardiac surgery in order to understand the potential deleterious effects of atrial fibrillation
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