Advanced age and incidence of atrial fibrillation in the postoperative period of aortic valve replacement

Abstract

45Rev Bras Cir Cardiovasc | Braz J Cardiovasc SurgRev Bras Cir Cardiovasc 2014;29(1):45-50 Pivatto Júnior F, et al. -Advanced age and incidence of atrial fibrillation in the postoperative period of aortic valve replacement RBCCV 44205-1520 DOI: 10.5935/1678 Advanced age and incidence of atrial fibrillation in the postoperative period of aortic valve replacementIdade avançada e incidência de fibrilação atrial em pós-operatório de troca valvar aórtica ORIGINAL ARTICLE Abstract Objective: This study aims to describe the correlation between age and occurrence of atrial fibrillation after aortic stenosis surgery in the elderly as well as evaluate the influence of atrial fibrillation on the incidence of strokes, hospital length of stay, and hospital mortality.Methods: Cross-sectional retrospective study of ≥ 70 yearold patients who underwent isolated aortic valve replacement.Results: 348 patients were included in the study (mean age 76.8±4.6 years). Overall, post-operative atrial fibrillation was 32.8% (n=114), but it was higher in patients aged 80 years and older (42.9% versus 28.8% in patients aged 70-79 years, P=0.017). There was borderline significance for linear correlation between age and atrial fibrillation (P=0.055). Intensive Care Unit and hospital lengths of stay were significantly increased in atrial fibrillation (P<0.001), but there was no increase in mortality or stroke associated with atrial fibrillation.Conclusion: Post-operative atrial fibrillation incidence in aortic valve replacement is high and correlates with age in patients aged 70 years and older and significantly more pronounced in patients aged 80 years. There was increased length of stay at Intensive Care Unit and hospital, but there was no increase in mortality or stroke. These data are important for planning prophylaxis and early treatment for this subgroup. Rev Bras Cir Cardiovasc 2014;29(1):45-50 Pivatto Júnior F, et al. -Advanced age and incidence of atrial fibrillation in the postoperative period of aortic valve replacement the incidence of postoperative CVA, hospital length of stay, and hospital mortality. Descriptors

Predictive factors of atrial fibrillation after coronary artery bypass grafting

“…In fact, such result should be confirmed in future studies because evidences suggest that calcium overload from the reperfusion of ischemic areas is one of the underlying arrhythmogenic mechanisms of arrhythmias after the heart surgeries. (21) In addition, the use of blocking calcium channels in prophylaxis of POAF is controversial. (22,23) …”

Long-term consequences of atrial fibrillation after aortic valve replacement

“…This incidence is comparable with previously reported incidences of 20% to 74%. 2,5,8–13 Furthermore, at a mean follow-up of 4.4 years (maximum 16.7 years), mortality in patients who had AF in our series was 2.8 deaths per 100 patient-years; this finding deserves attention given that the mortality of those who maintained sinus rhythm was only 0.2 deaths per 100 patient-years.…”

Preoperative Antihypertensive Medication in Relation to Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery: A Meta-Analysis

“…The characteristics of all included studies were presented in Table 1 . Most patients underwent CABG only; three studies reported Aortic valve replacements alone [ 14 , 24 , 30 ]. The type of cardiac operation in five studies contained CABG and valve operation [ 6 , 13 , 15 , 22 , 23 ].…”

“…Eleven studies were cohorts [ 8 , 10 , 13 , 23 , 24 , 26 – 31 ] and the rest were case-control studies [ 6 , 7 , 9 , 12 , 14 – 22 , 25 ]. The quality of the included studies was assessed by NOS score.…”