Postoperative atrial fibrillation after cardiac surgery was associated with reduced long-term survival (ΔRMST 0.45 years lost over 10 years; 95% CI 0.36-0.55) and increased heart failure.
Cohort (n=19,316)
No
Does postoperative atrial fibrillation reduce long-term survival and increase heart failure hospitalization in adult patients undergoing cardiac surgery?
Postoperative atrial fibrillation after cardiac surgery is associated with significantly reduced long-term survival and an increased risk of heart failure hospitalization over 10 years.
Mean Difference: 0.45 (95% CI 0.36–0.55)
BACKGROUND: Postoperative atrial fibrillation (POAF) is the most common complication following cardiac surgery, yet contemporary procedure-specific data on its incidence, temporal trends, and long-term prognostic impact are limited. METHODS: We conducted a retrospective cohort study of consecutive adult patients undergoing cardiac surgery between January 2010 and April 2024 at a single quaternary referral center. Patients with prior atrial fibrillation, concomitant Maze procedures, or death within 30 days were excluded. POAF was defined as any new-onset atrial fibrillation during the index hospitalization up to 30 days. Outcomes were assessed using multivariable Cox regression, restricted mean survival time (RMST), with adjustment for demographic, clinical, and procedural covariates. RESULTS: 19,316 patients undergoing cardiac surgery including isolated coronary artery bypass grafting (CABG), valve surgery, aortic surgery, or multicomponent procedures were included. POAF occurred in 6,333 patients (32.8%). Incidence varied by procedure: combined CABG and valve 48.0%, CABG and aortic 46.3%, isolated valve 36.9-37.0%, and isolated CABG 29.4%. Overall POAF incidence declined by 3.7% annually (95% CI 2.9-4.5%). After adjustment, POAF was associated with reduced long-term survival (ΔRMST 0.45 years lost over 10 years, 95% CI 0.36-0.55), greatest in multicomponent procedures (0.64 years lost) and CABG (0.47 years lost). POAF was also associated with higher heart failure hospitalization at 10 years (absolute difference 5.8%, 95% CI 4.1-7.5%) but not with stroke in competing risk models. CONCLUSION: Although the incidence of POAF has declined over time, it remains common and is associated with significant long-term adverse outcomes, including reduced survival and increased heart failure hospitalization.
Jacquemyn et al. (Fri,) conducted a cohort in Postoperative atrial fibrillation after cardiac surgery (n=19,316). Postoperative atrial fibrillation vs. No postoperative atrial fibrillation was evaluated on Long-term survival (ΔRMST 0.45 years lost, 95% CI 0.36-0.55). Postoperative atrial fibrillation after cardiac surgery was associated with reduced long-term survival (ΔRMST 0.45 years lost over 10 years; 95% CI 0.36-0.55) and increased heart failure.