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Atrial fibrillation after cardiac surgery: incidence, risk factors, and economic burden.

Abstract：

OBJECTIVE:To evaluate the incidence of postoperative atrial fibrillation (POAF), the predisposing factors, the results of treatment before discharge, and the impact on duration and costs of hospitalization. DESIGN:A prospective observational study. METHODS:Patients who underwent cardiac surgery from January 1, 2007 to December 31, 2007. INTERVENTIONS:Electrocardiography was continuously monitored after surgery. Patients with symptomatic new-onset atrial fibrillation or lasting >15 minutes were treated with amiodarone and with DC shock in prolonged cases. RESULTS:POAF occurred in 29.7%, with the higher incidence between the 1st and 4th postoperative day. Age (p < 0.001), atrial size >40 mm (p < 0.001), previous episodes of AF (p < 0.001), female sex (p = 0.010), and combined valve and bypass surgery (p = 0.012) were multivariate predictors of POAF at logistic regression. Sinus rhythm was restored by early treatment in 205 of 215 patients. This was associated with a low incidence of cerebrovascular events (<0.5%) and with a limited increase of average length of hospitalization (24 hours) in patients with POAF. CONCLUSIONS:The overall incidence of POAF in the authors' center is close to 30%; 95.3% of patients were discharged in sinus rhythm. The increase in length and costs of hospitalization (on average, 1.0 day with a burden of about €1,800/patient) were significantly lower than in previous investigations.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Rostagno C,La Meir M,Gelsomino S,Ghilli L,Rossi A,Carone E,Braconi L,Rosso G,Puggelli F,Mattesini A,Stefàno PL,Padeletti L,Maessen J,Gensini GF

doi

10.1053/j.jvca.2010.03.009

subject

Has Abstract

pub_date

2010-12-01 00:00:00

pages

952-8

issue

6

eissn

1053-0770

issn

1532-8422

pii

S1053-0770(10)00103-5

journal_volume

24

pub_type

杂志文章

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