Risk Factors for Postoperative Atrial Fibrillation in Myocardial Revascularization Surgery: A 15-Year Experience.
Diana Marcela Bonilla-BonillaLuis Miguel Osorio-ToroJorge Enrique Daza-AranaJhon H Quintana-OspinaJuan Carlos Ávila-ValenciaHeiler Lozada-RamosPublished in: Journal of clinical medicine (2024)
Background: Myocardial revascularization surgery (MRV) is a revascularization therapy for coronary artery disease aimed at improving survival conditions. Elderly patients with increased comorbidities undergoing MRV face challenges in preventing postoperative complications, including atrial fibrillation (AF), a common arrhythmia occurring in 40% of cases or even in 80% of cases if the procedure is combined with valve surgery. This study aimed to determine the risk factors associated with the appearance of postoperative AF (POAF) in patients undergoing isolated MRV. Methods: This is an epidemiological, retrospective, and analytical case-control study (90 cases and 360 controls). Results: Mortality within the group of patients who presented with POAF in the study population was 15.5%, and 9.44% in the control group. Logistic regression showed an association of AF with the presurgical variables age >60 years and urgent/emergency surgery and the postsurgical variables cardiogenic shock, blood transfusion, pulmonary edema, pleural effusion, orotracheal reintubation, and mechanical ventilation time. Conclusions: Strategies should be proposed for the timely identification of risk factors and postoperative complications related to AF onset to avoid the increased morbidity and mortality associated with this type of arrhythmia during the postoperative period.
Keyphrases
- atrial fibrillation
- minimally invasive
- percutaneous coronary intervention
- coronary artery bypass
- patients undergoing
- catheter ablation
- coronary artery disease
- mechanical ventilation
- risk factors
- coronary artery bypass grafting
- left atrial
- oral anticoagulants
- surgical site infection
- left atrial appendage
- left ventricular
- direct oral anticoagulants
- healthcare
- intensive care unit
- public health
- cardiovascular events
- emergency department
- pulmonary hypertension
- cardiovascular disease
- mitral valve
- type diabetes
- cross sectional