Predictors of Late Atrial Fibrillation Recurrence After Cardiac Surgery
Although postoperative atrial fibrillation (POAF) frequently occurs early after cardiac surgery, there is a paucity of data evaluating predictors and timing of late atrial fibrillation (AF) recurrence. The authors sought to evaluate predictors of late AF recurrence in patients undergoing cardiac sur...
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| Veröffentlicht in: | JACC. Clinical electrophysiology 2024-07, Vol.10 (7), p.1711-1719 |
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| creator | William, Jeremy Rowe, Kate Hogarty, Joseph Xiao, Xiaoman Shirwaiker, Anita Bloom, Jason E. Marasco, Silvana Zimmet, Adam Merry, Christopher Negri, Justin Doi, Atsuo Gooi, Julian McGiffin, David Kalman, Jonathan M. Prabhu, Sandeep Kistler, Peter M. Voskoboinik, Aleksandr |
| description | Although postoperative atrial fibrillation (POAF) frequently occurs early after cardiac surgery, there is a paucity of data evaluating predictors and timing of late atrial fibrillation (AF) recurrence.
The authors sought to evaluate predictors of late AF recurrence in patients undergoing cardiac surgery.
We retrospectively reviewed cardiac surgery patients from 2010 to 2018 with no preoperative diagnosis of AF or atrial flutter. We recorded incidence and timing of late AF recurrence, defined as occurring ≥12 months following surgery.
1,031 patients were included (mean age at surgery 64 ± 12 years, 74% male). Early POAF was recorded in 445 patients (43%). POAF was usually transient, with total AF duration 48 hours. In a multivariable analysis, early POAF duration >48 hours was a significant predictor of late AF recurrence (HR: 5.9). Surgery type and CHA2DS2-VASc score were not predictive of late AF events.
Post-operative AF episodes of duration ≥48 hours predict recurrent AF episodes over long-term follow-up after cardiac surgery. Implications for arrhythmia surveillance and anticoagulation in patients with longer duration POAF episodes require further study.
[Display omitted] |
| doi_str_mv | 10.1016/j.jacep.2024.05.030 |
| format | Article |
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The authors sought to evaluate predictors of late AF recurrence in patients undergoing cardiac surgery.
We retrospectively reviewed cardiac surgery patients from 2010 to 2018 with no preoperative diagnosis of AF or atrial flutter. We recorded incidence and timing of late AF recurrence, defined as occurring ≥12 months following surgery.
1,031 patients were included (mean age at surgery 64 ± 12 years, 74% male). Early POAF was recorded in 445 patients (43%). POAF was usually transient, with total AF duration <48 hours in 72% and reversion to sinus rhythm at discharge in 91%. At 4.7 ± 2.4 years follow-up, late AF occurred in 139 patients (14%). Median time to AF recurrence was 4.4 years post-surgery (Q1-Q3: 2.6-6.2 years). Late AF was significantly more likely among patients with early POAF than those without (23% vs 6%; P < 0.001), with highest incidence (38%) in those with POAF duration >48 hours. In a multivariable analysis, early POAF duration >48 hours was a significant predictor of late AF recurrence (HR: 5.9). Surgery type and CHA2DS2-VASc score were not predictive of late AF events.
Post-operative AF episodes of duration ≥48 hours predict recurrent AF episodes over long-term follow-up after cardiac surgery. Implications for arrhythmia surveillance and anticoagulation in patients with longer duration POAF episodes require further study.
[Display omitted]</description><identifier>ISSN: 2405-500X</identifier><identifier>ISSN: 2405-5018</identifier><identifier>EISSN: 2405-5018</identifier><identifier>DOI: 10.1016/j.jacep.2024.05.030</identifier><identifier>PMID: 39084745</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; anticoagulation ; atrial fibrillation ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - etiology ; cardiac surgery ; Cardiac Surgical Procedures - adverse effects ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Complications - epidemiology ; Recurrence ; Retrospective Studies ; Risk Factors ; Time Factors</subject><ispartof>JACC. Clinical electrophysiology, 2024-07, Vol.10 (7), p.1711-1719</ispartof><rights>2024</rights><rights>Copyright © 2024. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c239t-e1f149529c11aeeb22324a67aa07e0f5b58b3dc4ae81c4f2d6c9c91dde7ae0263</cites><orcidid>0000-0003-3936-5421</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39084745$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>William, Jeremy</creatorcontrib><creatorcontrib>Rowe, Kate</creatorcontrib><creatorcontrib>Hogarty, Joseph</creatorcontrib><creatorcontrib>Xiao, Xiaoman</creatorcontrib><creatorcontrib>Shirwaiker, Anita</creatorcontrib><creatorcontrib>Bloom, Jason E.</creatorcontrib><creatorcontrib>Marasco, Silvana</creatorcontrib><creatorcontrib>Zimmet, Adam</creatorcontrib><creatorcontrib>Merry, Christopher</creatorcontrib><creatorcontrib>Negri, Justin</creatorcontrib><creatorcontrib>Doi, Atsuo</creatorcontrib><creatorcontrib>Gooi, Julian</creatorcontrib><creatorcontrib>McGiffin, David</creatorcontrib><creatorcontrib>Kalman, Jonathan M.</creatorcontrib><creatorcontrib>Prabhu, Sandeep</creatorcontrib><creatorcontrib>Kistler, Peter M.</creatorcontrib><creatorcontrib>Voskoboinik, Aleksandr</creatorcontrib><title>Predictors of Late Atrial Fibrillation Recurrence After Cardiac Surgery</title><title>JACC. Clinical electrophysiology</title><addtitle>JACC Clin Electrophysiol</addtitle><description>Although postoperative atrial fibrillation (POAF) frequently occurs early after cardiac surgery, there is a paucity of data evaluating predictors and timing of late atrial fibrillation (AF) recurrence.
The authors sought to evaluate predictors of late AF recurrence in patients undergoing cardiac surgery.
We retrospectively reviewed cardiac surgery patients from 2010 to 2018 with no preoperative diagnosis of AF or atrial flutter. We recorded incidence and timing of late AF recurrence, defined as occurring ≥12 months following surgery.
1,031 patients were included (mean age at surgery 64 ± 12 years, 74% male). Early POAF was recorded in 445 patients (43%). POAF was usually transient, with total AF duration <48 hours in 72% and reversion to sinus rhythm at discharge in 91%. At 4.7 ± 2.4 years follow-up, late AF occurred in 139 patients (14%). Median time to AF recurrence was 4.4 years post-surgery (Q1-Q3: 2.6-6.2 years). Late AF was significantly more likely among patients with early POAF than those without (23% vs 6%; P < 0.001), with highest incidence (38%) in those with POAF duration >48 hours. In a multivariable analysis, early POAF duration >48 hours was a significant predictor of late AF recurrence (HR: 5.9). Surgery type and CHA2DS2-VASc score were not predictive of late AF events.
Post-operative AF episodes of duration ≥48 hours predict recurrent AF episodes over long-term follow-up after cardiac surgery. Implications for arrhythmia surveillance and anticoagulation in patients with longer duration POAF episodes require further study.
[Display omitted]</description><subject>Aged</subject><subject>anticoagulation</subject><subject>atrial fibrillation</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - etiology</subject><subject>cardiac surgery</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Complications - epidemiology</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><issn>2405-500X</issn><issn>2405-5018</issn><issn>2405-5018</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1Lw0AQhhdRtGh_gSA5emmc_crHwUMpWoWC4gd4Wza7E9nQNnU2EfrvTa169DQD877zzjyMnXNIOfDsqkkb63CTChAqBZ2ChAM2Egr0RAMvDv96eDth4xgbAOBaFIKrY3YiSyhUrvSIzR8JfXBdSzFp62RhO0ymHQW7TG5DRWG5tF1o18kTup4I124Y1x1SMrPkg3XJc0_vSNszdlTbZcTxTz1lr7c3L7O7yeJhfj-bLiZOyLKbIK-5KrUoHecWsRJCCmWz3FrIEWpd6aKS3imLBXeqFj5zpSu595hbBJHJU3a537uh9qPH2JlViA6HM9fY9tFIKLJSa5nzQSr3UkdtjIS12VBYWdoaDmYH0TTmG6LZQTSgzQBxcF38BPTVCv2f5xfZILjeC3B48zMgmejCDowPhK4zvg3_BnwBCiKDZQ</recordid><startdate>202407</startdate><enddate>202407</enddate><creator>William, Jeremy</creator><creator>Rowe, Kate</creator><creator>Hogarty, Joseph</creator><creator>Xiao, Xiaoman</creator><creator>Shirwaiker, Anita</creator><creator>Bloom, Jason E.</creator><creator>Marasco, Silvana</creator><creator>Zimmet, Adam</creator><creator>Merry, Christopher</creator><creator>Negri, Justin</creator><creator>Doi, Atsuo</creator><creator>Gooi, Julian</creator><creator>McGiffin, David</creator><creator>Kalman, Jonathan M.</creator><creator>Prabhu, Sandeep</creator><creator>Kistler, Peter M.</creator><creator>Voskoboinik, Aleksandr</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3936-5421</orcidid></search><sort><creationdate>202407</creationdate><title>Predictors of Late Atrial Fibrillation Recurrence After Cardiac Surgery</title><author>William, Jeremy ; Rowe, Kate ; Hogarty, Joseph ; Xiao, Xiaoman ; Shirwaiker, Anita ; Bloom, Jason E. ; Marasco, Silvana ; Zimmet, Adam ; Merry, Christopher ; Negri, Justin ; Doi, Atsuo ; Gooi, Julian ; McGiffin, David ; Kalman, Jonathan M. ; Prabhu, Sandeep ; Kistler, Peter M. ; Voskoboinik, Aleksandr</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c239t-e1f149529c11aeeb22324a67aa07e0f5b58b3dc4ae81c4f2d6c9c91dde7ae0263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>anticoagulation</topic><topic>atrial fibrillation</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - etiology</topic><topic>cardiac surgery</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Complications - epidemiology</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>William, Jeremy</creatorcontrib><creatorcontrib>Rowe, Kate</creatorcontrib><creatorcontrib>Hogarty, Joseph</creatorcontrib><creatorcontrib>Xiao, Xiaoman</creatorcontrib><creatorcontrib>Shirwaiker, Anita</creatorcontrib><creatorcontrib>Bloom, Jason E.</creatorcontrib><creatorcontrib>Marasco, Silvana</creatorcontrib><creatorcontrib>Zimmet, Adam</creatorcontrib><creatorcontrib>Merry, Christopher</creatorcontrib><creatorcontrib>Negri, Justin</creatorcontrib><creatorcontrib>Doi, Atsuo</creatorcontrib><creatorcontrib>Gooi, Julian</creatorcontrib><creatorcontrib>McGiffin, David</creatorcontrib><creatorcontrib>Kalman, Jonathan M.</creatorcontrib><creatorcontrib>Prabhu, Sandeep</creatorcontrib><creatorcontrib>Kistler, Peter M.</creatorcontrib><creatorcontrib>Voskoboinik, Aleksandr</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>JACC. Clinical electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>William, Jeremy</au><au>Rowe, Kate</au><au>Hogarty, Joseph</au><au>Xiao, Xiaoman</au><au>Shirwaiker, Anita</au><au>Bloom, Jason E.</au><au>Marasco, Silvana</au><au>Zimmet, Adam</au><au>Merry, Christopher</au><au>Negri, Justin</au><au>Doi, Atsuo</au><au>Gooi, Julian</au><au>McGiffin, David</au><au>Kalman, Jonathan M.</au><au>Prabhu, Sandeep</au><au>Kistler, Peter M.</au><au>Voskoboinik, Aleksandr</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of Late Atrial Fibrillation Recurrence After Cardiac Surgery</atitle><jtitle>JACC. Clinical electrophysiology</jtitle><addtitle>JACC Clin Electrophysiol</addtitle><date>2024-07</date><risdate>2024</risdate><volume>10</volume><issue>7</issue><spage>1711</spage><epage>1719</epage><pages>1711-1719</pages><issn>2405-500X</issn><issn>2405-5018</issn><eissn>2405-5018</eissn><abstract>Although postoperative atrial fibrillation (POAF) frequently occurs early after cardiac surgery, there is a paucity of data evaluating predictors and timing of late atrial fibrillation (AF) recurrence.
The authors sought to evaluate predictors of late AF recurrence in patients undergoing cardiac surgery.
We retrospectively reviewed cardiac surgery patients from 2010 to 2018 with no preoperative diagnosis of AF or atrial flutter. We recorded incidence and timing of late AF recurrence, defined as occurring ≥12 months following surgery.
1,031 patients were included (mean age at surgery 64 ± 12 years, 74% male). Early POAF was recorded in 445 patients (43%). POAF was usually transient, with total AF duration <48 hours in 72% and reversion to sinus rhythm at discharge in 91%. At 4.7 ± 2.4 years follow-up, late AF occurred in 139 patients (14%). Median time to AF recurrence was 4.4 years post-surgery (Q1-Q3: 2.6-6.2 years). Late AF was significantly more likely among patients with early POAF than those without (23% vs 6%; P < 0.001), with highest incidence (38%) in those with POAF duration >48 hours. In a multivariable analysis, early POAF duration >48 hours was a significant predictor of late AF recurrence (HR: 5.9). Surgery type and CHA2DS2-VASc score were not predictive of late AF events.
Post-operative AF episodes of duration ≥48 hours predict recurrent AF episodes over long-term follow-up after cardiac surgery. Implications for arrhythmia surveillance and anticoagulation in patients with longer duration POAF episodes require further study.
[Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39084745</pmid><doi>10.1016/j.jacep.2024.05.030</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-3936-5421</orcidid></addata></record> |
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| subjects | Aged anticoagulation atrial fibrillation Atrial Fibrillation - epidemiology Atrial Fibrillation - etiology cardiac surgery Cardiac Surgical Procedures - adverse effects Female Humans Incidence Male Middle Aged Postoperative Complications - epidemiology Recurrence Retrospective Studies Risk Factors Time Factors |
| title | Predictors of Late Atrial Fibrillation Recurrence After Cardiac Surgery |
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