Is the Risk of Postoperative Atrial Fibrillation Predictable in Patients Undergoing Surgery Due to Primary Lung Cancer?

Kavurmacı, Önder; Akçam, Tevfik İlker; Ergönül, Ayşe Gül; Turhan, Kutsal; Çakan, Alpaslan; Çağırıcı, Ufuk

doi:10.1016/j.hlc.2017.06.729

Cited by 9 publications

(7 citation statements)

References 18 publications

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“…In a recent paper by Kavurmaci et al [39], considering patients who underwent lung resection due to primary lung cancer, authors found that older age and chronic obstructive pulmonary disease (COPD) were significant predictors of PAF.…”

Section: Risk Factors Triggers and Pathophysiology Of Pafmentioning

confidence: 99%

Incidence, Management, Prevention and Outcome of Post-Operative Atrial Fibrillation in Thoracic Surgical Oncology

Fabiani

Colombo

Bacchiani

et al. 2019

JCM

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Atrial fibrillation (AF) is a common supraventricular arrhythmia, a recognized risk factor for ischemic stroke, as a potential driver for heart failure (HF). Cancer patients have an increased risk for AF, even not including any cancer-specific treatment, as surgery or chemotherapy. The mechanism is multifactorial, with inflammation and changes in autonomic tone as critical actors. Commonly, AF is a recurrent complication of the post-operative period in cancer surgery (especially thoracic). Recent papers confirmed a significant incidence of post-operative (non-cardiac surgery) AF (PAF), partially mitigated by the use of prophylactic (rate o rhythm control) treatments. A relevant difference, in terms of mean hospitalization time, emerges between patients developing PAF and those who do not, while long term impact remains a matter of debate, due to several potential confounding factors. Besides clinical predictors, structural (i.e., echocardiographic) and bio-humoral findings may help in risk prediction tasks. In this respect, pre-operative natriuretic peptides (NPs) concentrations are nowadays recognized as significant independent predictors of perioperative cardiovascular complications (including PAF), while elevated post-operative levels may further enhance risk stratification. The aim of the present paper is to trace the state of the art in terms of incidence, management, prevention, and outcome of PAF in the field of thoracic surgical oncology.

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Section: Risk Factors Triggers and Pathophysiology Of Pafmentioning

confidence: 99%

Incidence, Management, Prevention and Outcome of Post-Operative Atrial Fibrillation in Thoracic Surgical Oncology

Fabiani

Colombo

Bacchiani

et al. 2019

JCM

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“…In a study conducted by Takuya on 607 patients, it was concluded that the incidence of POAF was higher in lobectomy than segmentectomy regarding lung cancer in stage IA [10]. In most studies, aging was mentioned as a significant predictor of POAF occurrence [6, 9, 17, 18]. In the current study, there was a significant difference between the patients with arrhythmia and non-arrhythmia groups in terms of age.…”

Section: Discussionmentioning

confidence: 44%

“…However, POAF prevalence was higher in men in the present study. The mean duration of hospitalization for patients with POAF was longer in most studies than in patients without arrhythmias [17]. In the current study patients with postoperative atrial fibrillation required longer hospitalization.…”

Section: Discussionmentioning

confidence: 52%

“…In a study performed by Darvis, the history of atrial fibrillation and the use of antiarrhythmic drugs were mentioned as the most important predictors of postoperative atrial fibrillation [6]. In a study by Kavurmaci et al , the presence of COPD led to an increase in the incidence of POAF [17]. In a study by Garner, postoperative infection was one of the most important factors in the occurrence of POAF.…”

Section: Discussionmentioning

confidence: 99%

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Atrial fibrillation after lung surgery: incidence, underlying factors, and predictors

Bagheri¹,

Yousefi²,

Rezai³

et al. 2019

kitp

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Introduction Cardiac complications are the second most common cause of morbidity and mortality in patients subjected to thoracic surgery after respiratory complications. Postoperative arrhythmia is one of the most common cardiac complications in these patients. It leads to morbidity, increased hospitalization, and high costs for patients. Aim To determine the incidence of atrial fibrillation after lung resection and determine the underlying factors and predictors of this problem. Material and methods The participants in this study were composed of all patients who were subjected to lung resection surgery in the past 4 years. The demographic data of the patients and possible postoperative complications, including the incidence of atrial fibrillation, were extracted from patient records. The statistical analysis of data was performed after data collection. Results The incidence of postoperative atrial fibrillation (POAF) in the present study was 7.6% ( n = 20), mostly in patients who had a lung parenchyma resection. It occurred due to malignancy ( n = 16), squamous cell carcinoma ( n = 9), adenoid cystic carcinoma ( n = 5), and metastasis ( n = 2). The POAF occurred in 34.2% of pneumonectomy cases and 4.5% of lobectomy cases, out of whom 60% were male. There was a significant difference between the two groups of arrhythmia and non-arrhythmia groups regarding the age range. The mean ages of patients with and without arrhythmias were 56.45 ±18.2 and 44.76 ±17.2, respectively. Conclusions Pulmonary malignant pathologies are more likely to develop POAF due to the need for lung resection and possibly mediastinal lymphadenectomy that stimulates the heart and pericardium and the vagus nerve.

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“…While atrial fibrillation is usually considered to be an unhazardous and transient arrhythmia, POAF is associated with a poorer prognosis regarding morbidity and mortality [3] [4]. The etiology and pathophysiological interactions, which leads to the development of POAF, remains unknown, although, studies have shown a higher risk correlating with age, male sex, obesity, hypertension, extent of surgery, prior atrial fibrillation (AF) or arrhythmia, history of heart disease, chronic obstructive pulmonary disease (COPD) and brain natriuretic peptide (BNP) levels [2] [3] [4] [6].…”

Section: Introductionmentioning

confidence: 99%

Amiodarone for Postoperative Atrial Fibrillation in Lung Cancer Patients: A 6-Year Follow-Up Study

Enevoldsen¹,

Borregaard

Riber

et al. 2020

OJTS

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Background: The preventive effect of prophylactic amiodarone on postoperative atrial fibrillation (POAF) in patients undergoing thoracic surgery has previously been demonstrated. Meanwhile, the long-term effect remains unknown. We investigated the long-term effect of prophylactic amiodarone, in patients undergoing surgery for lung cancer, along with the long-term prognosis of patients with POAF within 6 years of follow-up. Methods: Using data from national databases, we retrospectively analysed 250 patients included and randomized, in the randomized control trial, PASCART, in which patients were allocated to receive either amiodarone or placebo as prophylaxis for POAF. Prophylactic groups, and subgroups, were compared on a number of outcomes. Long-term overall survival was evaluated using Kaplan-Meier survival curves, and Cox proportional hazards models were used for multivariable analysis. Competing risk analysis was used to evaluate time-to-event data in presence of competing risk. Results: When comparing the prophylactic groups, prophylaxis with amiodarone was not convincingly related to a higher frequency of long-term side effects. Patients who developed POAF, were more likely to develop late atrial fibrillation (AF) and POAF was associated with an increased risk of late AF in both the competing risk analysis hazard rate (HR) 4.80 [95% 1.75; 13.18] and multivariable analysis of the Cox regression, HR 5.03 [95% 1.80; 14.10]. When comparing the Kaplan Meier survival curves between groups, we found no statistically significant difference in the long-term overall survival. Conclusions: Intravenous prophylactic amiodarone is safe in patients undergoing lung cancer surgery. POAF is associated with an increased risk of late AF.

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Is the Risk of Postoperative Atrial Fibrillation Predictable in Patients Undergoing Surgery Due to Primary Lung Cancer?

Cited by 9 publications

References 18 publications

Incidence, Management, Prevention and Outcome of Post-Operative Atrial Fibrillation in Thoracic Surgical Oncology

Incidence, Management, Prevention and Outcome of Post-Operative Atrial Fibrillation in Thoracic Surgical Oncology

Atrial fibrillation after lung surgery: incidence, underlying factors, and predictors

Amiodarone for Postoperative Atrial Fibrillation in Lung Cancer Patients: A 6-Year Follow-Up Study

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