Postoperative Atrial Fibrillation Is Not Associated With an Increase Risk of Stroke or the Type and Number of Grafts: A Single‐Center Retrospective Analysis

Abstract

Background:Atrial fibrillation (AF) and atrial flutter are the 2 most common types of dysrhythmia in patients undergoing coronary artery bypass graft (CABG) surgery and are associated with increased morbidity and mortality. We sought to explore the association between the type and quantity of bypass grafts and cardiovascular outcomes in patients with postoperative AF (POAF).Hypothesis:The type and quantity of bypass grafts is associated with POAF.Methods:We queried the Society of Thoracic Surgery National Database for CABG operations, both with and without valve procedures, performed at Baystate Medical Center between January 2002 and July 2007. We used multivariable logistic regression modeling to identify predictors of POAF and to explore the impact of AF on major adverse cardiac outcomes in this post‐CABG population.Results:A total of 3068 patients received CABG surgery, 187 (6.1%) of whom received concurrent valve replacement or repair. The incidence of POAF was 38.3%. POAF was significantly associated with readmission within 30 days (P < 0.009), increased length of stay (P << 0.0001), and a strong trend toward increased 30 day mortality (P = 0.058). There was no association between POAF and postoperative stroke (P = 0.92), graft type (P = nonsignificant) or number of grafts (P = nonsignificant).Conclusions:Patients with POAF experienced increased morbidity and mortality as demonstrated by previous studies. Neither the number of grafts nor type of grafts was associated with POAF. Furthermore, the rate of stroke was not associated with POAF. © 2011 Wiley Periodicals, Inc.The authors have no funding, financial relationships, or conflicts of interest to disclose.

New Onset Postoperative Atrial Fibrillation is Associated with a Long-Term Risk for Stroke and Death Following Cardiac Surgery

“…Our findings and those of Kaw et al, Villareal et al, and El‐Chami et al are in contrast to single‐center series that have failed to identify an association between NwAfib and long‐term adverse events such as stroke or death . However, these studies, while at times very large, did not evaluate risk beyond 30 days and often included patients other than isolated CABG that may have a different risk profile for developing NwAfib.…”

Increased late mortality after coronary artery bypass surgery complicated by isolated new-onset atrial fibrillation: A comprehensive propensity-matched analysis

“…Consequently, the interplay between these nonarrhythmic complications and POAF might have confounded the independent effects of these conditions on operative and, possibly, late death. 2,8,9,11 Separating the late effects of POAF and concurrent complications is difficult, and studies, thus far, have either ignored this 13,26 or have relied on multivariate Cox regression modeling to account for some, but not all, such complications. 2,9,11,14,27 Finally, the potentially time-varying POAF effect on late mortality, its duration, and the period of greatest risk has not been described.…”

Fibrilación auricular posoperatoria ¿Un lobo con piel de cordero?

“…Su abatimiento se presenta como uno de los objetivos centrales en las estrategias de profilaxis de la FAPO y del tratamiento anticoagulante. Sin embargo, en algunos estudios no se comprueba una asociación independiente entre FAPO y ACV (8,(22)(23)(24) , proponiéndose mecanismos alternativos de producción. El empleo de una definición restrictiva de FAPO y/o la anticoagulación prolongada podrían explicar este resultado.…”

“…Varios estudios han señalado una incidencia significativamente mayor de IAM PO en pacientes que experimentan FAPO (21,22) . Si bien el IAM es una causa posible de esta arritmia, también la FA puede favorecer la complicación isquémica en un paciente recientemente revascularizado.…”