Assessment of the frequency and possible risk factors for paroxysmal atrial fibrillation in the early postoperative period after transapical implantation of the MedLab-CT valve

Abstract

Aim. To study the incidence and possible risk factors for atrial fibrillation (AF) in the early postoperative period after transapical implantation of the first domestic aortic valve (TAVI) “MedLab-CT”.Material and methods. The study included 118 patients after successful TAVI. The study did not include patients with open aortic valve replacement due to dislocation of the prosthesis, with severe intraoperative complications leading to the death of the patient, and patients with permanent AF. The mean age of the patients was 71.1 ± 4.9 years, body mass index was 31.1 ± 5.9 kg/m2, men were 39.8%, hypertension was in 93.2%, diabetes mellitus (DM) was in 27.9%, paroxysmal AF was in 12.7%, coronary heart disease (CHD) was in 56.7%, smoking was noted in 8.4% cases. The median follow-up time corresponded to the hospital stay - 9.5 days. To identify cardiac arrhythmias, daily regular ECG recordings in 12 leads were assessed from the first day after TAVI. In the presence of palpitations, 24-hour ECG monitoring was performed. Indicators such as age, male gender, DM, history of AF, interatrial block before surgery, CHD, and echocardiographic parameters were studied as possible predictors of AF development in the early postoperative period after TAVI. There were no significant differences in the studied parameters in patients with AF paroxysms and sinus rhythm.Results. In the early postoperative period, AF episodess occurred in 46 (39%) patients. New-onset AF occurred in 38 (32.2%) patients. The only statistically significant risk factor for AF in the postoperative period in our series of observations was CHD (OR 5.756; 95% CI 1.009-8.132; p = 0.048).Conclusion. Patients with paroxysmal AF in the early postoperative period were not detected cerebrovascular events. In the early postoperative period, the only significant predictor of AF was the presence of proven CHD in patients.