De novo atrial fibrillation post cardiac surgery : the Durban experience : cardiovascular topic

Abstract

Atrial fibrillation (AF) is the most common complication post cardiac surgery and results in elevated morbidity and mortality rates and healthcare costs. A pilot, retrospective study of the medical records of all adult patients developing de novo AF post surgery was undertaken at the cardiac surgical unit in Durban between 2009 and 2012. We aimed to describe the local experience of AF with a view to suggesting an adapted local treatment policy in relation to previously published data. Fifty-nine patients developed AF during the study period. AF occurred predominantly three or more days post surgery. Thirty-five patients required cardioversion and amiodarone to restore sinus rhythm. Return to the general ward (RGW) was 4.6 days longer than the institutional norm. Liberal peri-operative β-blocker and statin use is currently preferred to a formal prophylaxis strategy. Randomised, controlled trials are required to evaluate measures curbing prolonged length of stay and morbidity burdens imposed by AF on the local resource-constrained environment.

A review of the epidemiology of atrial fibrillation in sub‐Saharan Africa

“…Hypertension was the most frequently reported risk factor for AF, and the most prevalent, affecting at least one in three patients with AF . This is consistent with the global picture that shows that hypertension is the most common medical condition associated with AF, present in about 30% to 75% of patients with AF .…”

“…Hypertension was the most frequently reported risk factor for AF, and the most prevalent, affecting at least one in three patients with AF. 20,44,[54][55][56][58][59][60][65][66][67][68][69][70][71][72][73][74][75][76][77] This is consistent with the global picture that shows that hypertension is the most common medical condition associated with AF, present in about 30% to 75% of patients with AF. 89 This is a result of the high prevalence of hypertension in the general population, affecting about one billion adults worldwide.…”

“…AF was found in 9.5% of pregnant women with cardiac disease in South Africa, and in 5.1% of a group of HIV‐infected individuals from Cameroon . The incidence of AF (de novo) postcardiac surgery was 5.9% in a study in South Africa …”

“…Figure and Table S2 present data on risk factors or conditions associated with AF. Hypertension was the most reported risk factor for AF, as well as the most prevalent. Its prevalence varied from 10.3% to 70.6%, with one in three AF patients who had hypertension in 20 out of 21 studies.…”

“…64 The incidence of AF (de novo) postcardiac surgery was 5.9% in a study in South Africa. 65 Figure 1 and Table S2 present data on risk factors or conditions associated with AF. Hypertension was the most reported risk factor for AF, 20,44,[54][55][56][58][59][60][65][66][67][68][69][70][71][72][73][74][75][76][77] as well as the most prevalent.…”