Older Age Is the Strongest Predictor of Postoperative Atrial Fibrillation

Amar, David; Zhang, Hao; Leung, Denis H. Y.; Roistacher, Nancy; Kadish, Alan H.

doi:10.1097/00000542-200202000-00021

Cited by 188 publications

(124 citation statements)

References 21 publications

(38 reference statements)

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“…The association between AF and advanced age in the general population is well documented, 12 as it is the greatest incidence of AF in elderly patients in the early postoperative period after CABG. 13 Our study has confirmed the above findings during the postoperative period, but it is the first to show that beyond the 6-week postoperative period the incidence of AF is unrelated to age. Information available in this study is not enough to explain this finding.…”

Section: Discussionsupporting

confidence: 86%

Incidence and Clinical Consequences of Atrial Fibrillation Within 1 Year of First-Time Isolated Coronary Bypass Surgery

2003

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Background-Atrial fibrillation (AF) is the commonest complication during cardiac surgery, however, the long-term prevalence of AF following surgery and its clinical consequences remain unclear. Patients and Methods-To investigate this, 877 consecutive patients undergoing first time CABG were followed for 1 year. Rhythm disturbances were diagnosed from serial ECGs and documented notes. The arrhythmia was treated medically and/or by cardioversion. Results-Out of 877, 17 patients (1.9%) died in the hospital and out of the remaining 860 patients 844 (98.1%) had a complete 1-year follow-up. Patients were divided according to their age: Group I (50 to 59 years), Group II (60 to 69 years) and Group III (70 to 79 years). The prevalence of AF in the general population was taken from the Framingham Heart Study. Patients in groups I and II had a higher incidence of AF before the operation than the general population (1.5% versus 0.4% and 3.1% versus 1.6%, respectively, PϽ0.05) and also higher incidence of AF at the 1-year follow-up (2% versus 0.4% and 4.6% versus 1.6% respectively, PϽ0.05). The incidence of AF in group III did not differ from the general population before operation, at the 6-week and 1-year follow-ups. As expected most of the patients with preoperative AF remained in AF after 1-year of CABG surgery. Importantly, the incidence of newly developed AF was higher in patients that developed infection and renal dysfunction in the postoperative period. AF did not predict embolic events at any stage of the study. Conclusion-In conclusion, the incidence of AF for the first year following CABG is higher in patients Ͻ70 years but not in those Ͼ70 years when compared with the general population. AF was also associated to the occurrence of postoperative infection and renal dysfunction. Patients in this study were closely monitored and received timely appropriate treatment, and this may account for the absence of a relationship between AF and embolic events.

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Section: Discussionsupporting

confidence: 86%

Incidence and Clinical Consequences of Atrial Fibrillation Within 1 Year of First-Time Isolated Coronary Bypass Surgery

2003

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“…[26] Increased sympathetic activation and prolonged atrial conduction time by aging are likely responsible for PoAF development. [27] Amar et al [28] reported that in patients older than 60 years POAF was more common and Hosokawa et al [29] reported that for every additional 10-year increment in age, there was an associated 1.5 times increased risk for the development of POAF.…”

Section: Discussionmentioning

confidence: 99%

Validation of SYNTAX and clinical SYNTAX scores in predicting atrial fibrillation following on-pump coronary artery bypass grafting

Oktay¹

2017

Turk Gogus Kalp Dama

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“…22 The incidence of AF increases with age (34 yrs); indeed the strongest risk for postoperative AF is age >60 years. 23 Postoperative AF extends hospital stay with accompanying increased costs as well as a greater risk of stroke. 22,24 A better understanding of the mechanisms responsible for postoperative AF has led to the study of statins in this setting.…”

Section: Discussionmentioning

confidence: 99%

Statins as Antiarrhythmics: A Systematic Review Part I: Effects on Risk of Atrial Fibrillation

Abuissa

O’Keefe

Bybee

2009

Clinical Cardiology

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Background: Recent studies have demonstrated that statins may possess antiarrhythmic properties in addition to their lipid-lowering effects. Methods: Studies which reported the association of statins with the incidence of atrial arrhythmias were identified through a systematic review of published literature. Results: One randomized, placebo-controlled trial of 200 patients undergoing cardiac surgery showed that atorvastatin decreased the incidence of postoperative atrial fibrillation by 61%. Observational studies in patients with stable coronary disease, left ventricular dysfunction, or those undergoing cardiac or noncardiac surgery show that statin therapy is associated with an approximately 50% lower rate of atrial fibrillation. Two small randomized trials reported conflicting results: one showing that atorvastatin reduced the recurrence of AF after electrical cardioversion and the other finding that pravastatin did not. Conclusions: Published data suggests that statins may possess antiarrhythmic properties that reduce the propensity for atrial fibrillation. Most of this data is observational; more randomized, placebo-controlled trials are needed.

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Older Age Is the Strongest Predictor of Postoperative Atrial Fibrillation

Abstract: Advanced age and preoperative heart rate identify patients at high risk for development of AF after thoracic surgery. Postoperative AF occurs more frequently in patients with greater postoperative morbidity and length of hospitalization.

Cited by 188 publications

References 21 publications

Incidence and Clinical Consequences of Atrial Fibrillation Within 1 Year of First-Time Isolated Coronary Bypass Surgery

Incidence and Clinical Consequences of Atrial Fibrillation Within 1 Year of First-Time Isolated Coronary Bypass Surgery

Validation of SYNTAX and clinical SYNTAX scores in predicting atrial fibrillation following on-pump coronary artery bypass grafting

Statins as Antiarrhythmics: A Systematic Review Part I: Effects on Risk of Atrial Fibrillation

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