Clinical characteristics and prognostic implication of atrial fibrillation in the postoperative period of cardiac surgery with cardiopulmonary bypass

Introduction

Despite the latest innovations in surgical and cardiopulmonary bypass techniques, atrial fibrillation remains a common occurrence in patients undergoing heart surgery, and has been shown to increase the incidence of intra- and postoperative complications. For this reason, it is among the top 10 research topics in cardiovascular surgery.

Method

Observational, analytical, retrospective study carried out at the largest cardiovascular centre in Mexico. Adult patients (>18 years) with no history of atrial fibrillation who underwent on-pump heart surgery between 1 January 2022 and 31 December 2023 were included. Variables that have previously been correlated with postoperative atrial fibrillation (POAF) were evaluated.

Results

A total of 544 patients were included. The incidence of POAF was 23.8%. Overall in-hospital mortality was 5.9%. There was a significant difference in age between patients that developed postoperative atrial fibrillation and those that maintained sinus rhythm (62 years vs 57 years, p = < 0.01). Using a univariate logistic regression model, we found that POAF significantly predicts the occurrence of hospital-acquired pneumonia (OR 3.12, 95% CI 1.61−6.02, p = <0.01) and the requirement for renal replacement therapy (OR 3.04, 95% CI 1.34−6.86, p = <0.01).

Conclusions

Atrial fibrillation is a common arrhythmia in the postoperative period of on-pump heart surgery, and is a predictor of adverse outcomes. Prevention, early detection and treatment of POAF may have prognostic implications.