Early atrial fibrillation after valve replacement surgery for rheumatic heart diseases

Objective: Atrial arrhythmias can lead to discomfort and hemodynamic instability. The aim of this study was to determine the incidence and timing of development of atrial fibrillation (AF) after valvular replacement surgery for rheumatic heart disease and to know various risk factors for development of these arrhythmias. Materials and Methods: The study conducted over a period of 30 months with effect from August 2006 to February 2009. Patients of rheumatic valvular disease with normal preoperative sinus rhythm undergoing valve replacement under cardio pulmonary bypass were selected for the study. Results: A total of 28 out of 80 patients (35%) developed AF during the postoperative period in the hospital. Most of the episodes (46.42%) occurred between 24-48 h in intensive care unit (ICU). Age, preoperative history of intermittent AF, systemic hypertension, left atrial size (>50 mm), left ventricular ejection fraction 50 min were significantly related to the development of AF in the postoperative period (P < 0.05). Conclusion: Atrial arrhythmias are most frequent in the first 2-3 days after the cardiac surgery, but they can occur at any point in the recovery period. Age, preoperative history of intermittent AF, systemic hypertension, left atrial size (>50 mm), left ventricular ejection fraction 50 min are the factors that lead to AF in the postoperative period.