Determinants of atrial fibrillation after cardiac surgery

Abstract

Post-operative Atrial fibrillation (POAF) is a common complication post cardiac surgery. It can result in detrimental short-and long-term outcomes due to the increased risk of stroke, cardiac arrest and congestive heart failure in addition to prolonged intensive care and total hospital stay raising the overall healthcare cost. Accurately identifying predictors and biomarkers for POAF ensures that patients at greatest risk can be given the appropriate prophylactic measures; resources can be distributed to the groups who are most in need and where they will gain the optimum effect. Commonly recurring predictors can be investigated further to unveil the pathophysiology behind POAF, which has yet to be fully understood. This literature review aims to examine relevant studies on the proposed predictors of POAF: increased age, gender, history of atrial fibrillation, hypertension, cardiopulmonary bypass time and the use of beta blockers amongst others. This paper will discuss the significance of both the well-known and newfound risk factors to consolidate the areas that require further exploration in order to highlight those at risk and to unravel the mechanism behind POAF.

Colchicine for prevention of post-operative atrial fibrillation: Meta-analysis of randomized controlled trials

“…The exact pathophysiology of post-operative AF is remained to elucidate. It is regarded as multifactorial, including autonomic nervous system imbalance, pericardial inflammation, hypoxia, and metabolic and electrolyte disturbances ( 10 – 12 , 36 ). Mounting evidence suggests that inflammation is a major factor in the development of post-operative AF ( 12 , 36 ).…”

“…It is regarded as multifactorial, including autonomic nervous system imbalance, pericardial inflammation, hypoxia, and metabolic and electrolyte disturbances ( 10 – 12 , 36 ). Mounting evidence suggests that inflammation is a major factor in the development of post-operative AF ( 12 , 36 ). Inflammatory biomarkers such as C-reactive protein and interleukin-6 are associated with the incidence of post-operative AF ( 13 – 15 , 37 , 38 ).…”

Inherited and Acquired Rhythm Disturbances in Sick Sinus Syndrome, Brugada Syndrome, and Atrial Fibrillation: Lessons from Preclinical Modeling

“…AF causes can be searched among different origins: genetic mutations, hormonal dysfunction, hemodynamic instability following cardiac interventions, athletic activity in endurance, and not lastly, radiation exposure, also during war [248][249][250][251][252][253]. Social determinants, such as age (over 65), ethnicity (mainly Hispanics and Asians), and health indicators of lifestyle quality (smoking, obesity, physical inactivity, psychological stresses) are considered risk factors of AF and the disease is associated with other pathological conditions, such as heart failure, myocardial infarction, chronic kidney disease, venous thromboembolism, dementia, and cancer.…”

Gut Microbiota in Patients with Postoperative Atrial Fibrillation Undergoing Off-Pump Coronary Bypass Graft Surgery

“…Post-operative atrial fibrillation (POAF) is the most common complication of cardiac surgery [ 1 , 2 , 3 ]. POAF is associated with long-term ischemic stroke, heart failure and mortality [ 4 ]. POAF increases the risk of ischemic stroke, heart failure hospitalization and recurrent atrial fibrillation (AF) [ 4 , 5 , 6 , 7 ].…”

“…POAF is associated with long-term ischemic stroke, heart failure and mortality [ 4 ]. POAF increases the risk of ischemic stroke, heart failure hospitalization and recurrent atrial fibrillation (AF) [ 4 , 5 , 6 , 7 ]. Therefore, decreasing POAF may be beneficial to prevent the long-term risk of adverse outcomes.…”