Introduction
Atrial fibrillation (AF) is the commonest arrhythmia and post-operative AF (POAF) is a frequent complication following cardiac surgery. Despite established guidelines, effective prevention of POAF remains limited in clinical practice.
Aim
Determine the relationship between demographic, surgical, pharmacological factors and POAF prevalence.
Method
Retrospective review of patient notes from September 2014-May 2015 for demographic, surgical and pharmacological features. Statistical analysis was prepared on SPSS. Score predictors for stroke and bleeding risk were manually calculated.
Results
The majority of patients had AF (53.50%, n=214), of these 196 had new onset AF and 18 had chronic AF preoperatively. There were more male patients that developed POAF (56.12%, n=196). The median age of POAF patients was 77(n=196)compared to those that didn’t 71(n=204). Operative factors associated with POAF include tissue valve replacement(p=0.04) and aortic root surgery(p=.001). POAF was associated with longer hospital stay (median=13, IQR=10-20). There is no significant difference in overall survival(p=0.161). The majority of POAF occurs in first 2 days (22.95%,n=196). No post-operative medication including, betablocker(p=0.385), angiotensin-converting-enzyme inhibitor(p=0.634), anticoagulant(p=0.378), anti-arrhythmic(p=0.528), loop-diuretics(p=0.991), calcium channel blocker(p=0.506) and anti-platelet(p=0.442) were associated with longterm survival for POAF patients. 85.20% patients(n=196) were a high-risk category for CHA₂DS₂-VASc score with significant difference in survival(p=0.047).
Conclusions
Despite adequate treatment following NICE guidelines, further studies are required to assess factors causing POAF. Documentation needed improvement to explore in-depth clinical changes between surgery and onset to POAF.
Authors
Siam Bhuiyan
University of Southampton, Southampton, United Kingdom