Atrial Fibrillation after Rheumatic Heart Valve Surgery: Incidence, Predictors, and Outcomes.

BACKGROUND

Atrial fibrillation after cardiac surgery (AFACS) impacts 10 to 65% of patients. AFACS is associated with stroke and other systemic embolic manifestations.

METHODS

Patients at our hospital who underwent valve surgery procedures including aortic valve replacement (AVR), mitral valve replacement (MVR), AVR with coronary artery bypass grafting (CABG), MVR with CABG, or AVR and MVR with/without CABG were included in this study in the period from .

RESULTS

In total, 346 patients were included in the current analysis, with a mean age of 51.6 ± 16.1 years, and 51% were males. .: Univariate predictors of AFACS included age, gender, body mass index (BMI), operation type, ejection fraction (EF), left atrial (LA) diameter, previous history of AF, use of aldosterone antagonists a month before surgery, use of diuretics a month before surgery, length of ICU stay, total length of stay, cross-clamp time 90 minutes, pump time 120 minutes, postoperative acute kidney injury, left ventricular dimensions.By multivariate analysis, only age ( = 0.028, AOR = 10.6), male gender ( = 0.021, ), type of surgery ( = 0.034, AOR = 7.12), history of AF ( = 0.018, AOR = : ), BMI ( < 0.001, ), EF before surgery ( ≤ 0.001, AOR = ), and LA diameter ( = 0.0051, AOR = 18.23) were independent predictors of AFACS.

CONCLUSION

This study identifies risk factors associated with the development of atrial fibrillation after rheumatic valve heart surgery. Older patients, male gender, type of surgery, preoperative AF, BMI, EF before surgery, and LA diameter are independent predictors of AF after cardiac valve surgery.