Predicting New-Onset Postoperative Atrial Fibrillation in Cardiac Surgery Patients

Tran, Diem; Perry, Jeffrey J.; Dupuis, Jean‐Yves; Elmestekawy, Elsayed; Wells, George

doi:10.1053/j.jvca.2014.12.012

Cited by 45 publications

(40 citation statements)

References 73 publications

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“…Similar to our results, Tran et al (20) reported that age was the only predictor of the development of POAF after cardiac surgery. They also reported that being > 65 years old is an important predictor of developing POAF (20).…”

Section: Discussionsupporting

confidence: 92%

Role of red blood cell distribution width and epicardial fat in atrial fibrillation after cardiopulmonary bypass

et al. 2018

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Objective: Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, and it remains a challenge for cardiac surgeons despite advances in medicine. A number of studies have been performed to examine various parameters to predict which patients will develop POAF. The present study was performed to investigate the roles of epicardial adipose tissue (EAT) volume and red blood cell distribution width (RDW) as predictors of POAF. Methods: The medical records of 350 patients undergoing coronary artery bypass grafting in one or more vessels at the Tertiary Cardiac Center, Cardiovascular Surgery Department, Mevlana (Rumi) University Private Hospital (Konya, Turkey), were screened between December 2011 and May 2015. The study population consisted of 149 patients fulfilling the inclusion criteria and undergoing a preoperative evaluation by computed chest tomography. All patient demographics and laboratory parameters were obtained from medical records. Results: Age, postoperative RDW, and tomography variables, including the left atrial (LA) volume, LA diameters, and EAT volume, were significantly higher while the hemoglobin level and hematocrit were significantly lower in patients developing atrial fibrillation after cardiopulmonary bypass. A logistic multivariate regression analysis was performed on age, postoperative RDW, and tomography variables, including LA volume, LA diameters and EAT volume. Only age (OR 1.0731, 95% CI 1.012-1.138; p = 0.018) was an independent predictor of the development of POAF. Conclusions: Although the EAT volume was high in patients developing atrial fibrillation after surgery, age was the only significant predictor of POAF on multivariate analysis. Additional studies regarding the predictive roles of epicardial fat and RDW in POAF are needed.

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Section: Discussionsupporting

confidence: 92%

Role of red blood cell distribution width and epicardial fat in atrial fibrillation after cardiopulmonary bypass

et al. 2018

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“…To the best of our knowledge, this is the first systematic review and meta‐analysis addressing the impact of postoperative AAs after lung transplantation. AAs are a well‐known complication after cardiac surgery . Risk factors include increasing age, prior AAs, COPD, left atrial enlargement, and postoperative medication (beta blockers, ACE inhibitors) withdrawal .…”

Section: Discussionmentioning

confidence: 99%

Adverse outcomes associated with postoperative atrial arrhythmias after lung transplantation: A meta‐analysis and systematic review of the literature

Waldron

Klinger

Hartwig

et al. 2017

Clinical Transplantation

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“…Advanced age strongly associated with POAF is the only consistent finding in all the studies (2,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21).…”

Section: Discussionmentioning

confidence: 56%

“…The predictive value of different analyzed models was in-fluenced by the variables involved and the number of patients included. Studies reporting risk factors for POAF have described different variables, but there are only a few prediction models, mainly for patients undergoing coronary artery bypass grafting (CABG) or combined surgical procedures (9,10,(14)(15)(16). Our aim was to test a population of patients undergoing SAVR, excluding other surgical procedures such as CABG or mitral valve surgery.…”

Section: Discussionmentioning

confidence: 99%

Postoperative atrial fibrillation prediction following isolated surgical aortic valve replacement

Iliescu¹

2018

Anatol J Cardiol

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ObjectivePostoperative atrial fibrillation (POAF) is the most common complication following cardiac surgery, with increased risk of stroke and high mortality. Our aim was to identify patients at risk and to design a model that could predict POAF.MethodsIn this single center study, we evaluated 1191 patients requiring isolated surgical aortic valve replacement between January 2000 and June 2014. The patients were followed during the early postoperative period until discharge.ResultsAF occurred in 342 patients (28.71%). Six variables associated with high arrhythmic risk [advanced age, body mass index, tricuspid regurgitation, prolonged ventilation, longer intensive care unit stay, and dilated left atrium (LA; volume ≥35 ml/m2)] were selected to create a multivariate prediction model. This model predicted POAF in 64.7% of cases, with a moderate discriminative power (AUC=0.65; p=0.001; 95% CI, 0.571-0.771). We also developed the CHAID (Chi-square automatic interaction detection) model showing multilevel interactions among risk factors for POAF. Age had the greatest discriminative power, with patients aged >68 years at a higher risk for POAF. In low-risk patients, the subgroup with dilated LA (volume ≥40 ml) was more prone to develop POAF. For the intermediate-risk group, history of AF was the next deciding variable, whereas for the high-risk group, it was tricuspid regurgitation (at least moderate).ConclusionThe multivariate logistic model has an acceptable predictive value. CHAID-derived model is a new tool that could be easily applied to identify patients requiring prophylactic regimens.

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Predicting New-Onset Postoperative Atrial Fibrillation in Cardiac Surgery Patients

Cited by 45 publications

References 73 publications

Role of red blood cell distribution width and epicardial fat in atrial fibrillation after cardiopulmonary bypass

Role of red blood cell distribution width and epicardial fat in atrial fibrillation after cardiopulmonary bypass

Adverse outcomes associated with postoperative atrial arrhythmias after lung transplantation: A meta‐analysis and systematic review of the literature

Postoperative atrial fibrillation prediction following isolated surgical aortic valve replacement

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