Perioperative Atrial Fibrillation in Noncardiac Surgeries for Malignancies and One-Year Recurrence

Higuchi, Satoshi; Kabeya, Yusuke; Matsushita, Kenichi; Arai, Nobuaki; Tachibana, Kaori; Tanaka, Ryota; Kawachi, Riken; Takei, Hidefumi; Suzuki, Yutaka; Kogure, Masaharu; Imanishi, Yorihisa; Moriyama, Kiyoshi; Sugiyama, Masanori; Yorozu, Tomoko; Saito, Koichiro; Abe, Nobutsugu; Kondo, Haruhiko; Yoshino, Hideaki

doi:10.1016/j.cjca.2019.07.008

Cited by 26 publications

(26 citation statements)

References 20 publications

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“…Our detection rate of 34% over 30 days of self-monitoring, is similar to the detection rate of 30% noted in a recent study that used an event recorder for ~14-days during months 1-, 6-, and 12 following discharge after surgery for malignancy [17] . To date, we are not aware of any other prospective studies that have reported on secondary AF recurrence after discharge, although a Canadian study is in progress [18] .…”

Section: Discussionsupporting

confidence: 88%

“…Similarly, a systematic review of monitoring for postoperative AF after cardiac surgery discharge, identified approximately 28% recurrence within 30-days, with various monitoring methods used [19] . Regardless of the patient group and method of monitoring, all studies have reported 50–93% of AF recurrences were asymptomatic, and palpitations occurred in only 7–30% of all recurrences [14] , [17] , [19] . Thus, our results appear to be consistent with the limited studies available, and it is likely that most AF recurrences will go undetected and not brought to the attention of the patients’ physician without explicit monitoring.…”

Section: Discussionmentioning

confidence: 99%

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Self-monitoring for recurrence of secondary atrial fibrillation following non-cardiac surgery or acute illness: A pilot study

Lowres

Hillis

Gladman

et al. 2020

IJC Heart & Vasculature

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Background Atrial fibrillation (AF) secondary to non-cardiac surgery and medical illness is common and, although often transient, is associated with an increased risk of stroke and mortality. This pilot study tested the feasibility of self-monitoring to detect recurrent AF in this setting and the frequency with which it occurred. Methods Patients with new secondary AF after non-cardiac surgery or medical illness that reverted to sinus rhythm before discharge were recruited in three tertiary hospitals in Australia. Participants performed self-monitoring for AF recurrence using a Handheld single-lead ECG device 3–4 times/day for 4-weeks. Results From 16,454 admissions, 224 (1.4%) secondary AF cases were identified. Of these, 94 were eligible, and 29 agreed to participate in self-monitoring (66% male; median age 67 years). Self-monitoring was feasible and acceptable to participants in this setting. Self-monitoring identified AF recurrence in 10 participants (34%; 95% CI, 18% −54%), with recurrence occurring ≤ 9 days following discharge in 9/10 participants. Only 4 participants (40%) reported associated palpitations with recurrence. Six participants (60%) with recurrence had a CHA 2 DS 2 -VA score ≥ 2, suggesting a potential indication for oral anticoagulation. Conclusions Approximately 1 in 3 patients with transient secondary AF will have recurrent AF within nine days of discharge. These recurrent episodes are often asymptomatic but can be detected promptly using patient self-monitoring, which was feasible and acceptable. Future research is warranted to further investigate the incidence of secondary AF, the rate of recurrence after discharge and its prognosis, and whether use of oral anticoagulation can reduce stroke in this setting.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Self-monitoring for recurrence of secondary atrial fibrillation following non-cardiac surgery or acute illness: A pilot study

Lowres

Hillis

Gladman

et al. 2020

IJC Heart & Vasculature

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“…In recent work on 377 patients who underwent anatomical pulmonary resection, the persistence of one-month arrhythmia was 7% [120]. Even more recently, Higuchi et al have shown a recurrence rate of 30% atrial fibrillation, mainly asymptomatic, in subjects undergoing cancer surgery, associated with the presence of arterial hypertension and renal failure [121].…”

Section: Long Term Implications Of Pafmentioning

confidence: 98%

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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“…A recent systematic review by our group found that perioperative AF is associated with an increased long-term risk of stroke, but that the absolute risk was somewhat lower than might be expected for typical AF patients. [16][17][18] Individual studies have reported similar findings in patients with medical illness. 5,15,17,19,20 We propose three plausible explanations for the intermediate risk of stress-associated AF (i.e.…”

Section: Discussionmentioning

confidence: 77%

Device-Detected Atrial Fibrillation Before and After Hospitalisation for Noncardiac Surgery or Medical Illness: Insights From ASSERT

McIntyre

Wang

Benz

et al. 2021

Canadian Journal of Cardiology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Perioperative Atrial Fibrillation in Noncardiac Surgeries for Malignancies and One-Year Recurrence

Cited by 26 publications

References 20 publications

Self-monitoring for recurrence of secondary atrial fibrillation following non-cardiac surgery or acute illness: A pilot study

Self-monitoring for recurrence of secondary atrial fibrillation following non-cardiac surgery or acute illness: A pilot study

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

Device-Detected Atrial Fibrillation Before and After Hospitalisation for Noncardiac Surgery or Medical Illness: Insights From ASSERT

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