Subacute postoperative atrial fibrillation after heart surgery: Incidence and predictive factors in cardiac rehabilitation
Abstract Background Postoperative atrial fibrillation (POAF) is the most common arrhythmia following cardiac surgery (CS). It may occur between the 1st and the 4th postoperative day as acute POAF or between the 5th and the 30th as subacute (sPOAF). sPOAF is associated with higher thromboembolic risk...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-02-01
|
| Series: | Journal of Arrhythmia |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/joa3.12956 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849521451552473088 |
|---|---|
| author | Vincenzo Rizza Francesco Maranta Lorenzo Cianfanelli Iside Cartella Francesco Maisano Ottavio Alfieri Domenico Cianflone |
| author_facet | Vincenzo Rizza Francesco Maranta Lorenzo Cianfanelli Iside Cartella Francesco Maisano Ottavio Alfieri Domenico Cianflone |
| author_sort | Vincenzo Rizza |
| collection | DOAJ |
| description | Abstract Background Postoperative atrial fibrillation (POAF) is the most common arrhythmia following cardiac surgery (CS). It may occur between the 1st and the 4th postoperative day as acute POAF or between the 5th and the 30th as subacute (sPOAF). sPOAF is associated with higher thromboembolic risk, which consistently increase patients' morbidity. Neutrophil‐to‐lymphocyte ratio (NLR) is a low‐cost inflammatory index proposed as possible POAF predictor. Identification of patients' risk categories might lead to improved postoperative outcomes. Methods The aim was to assess the incidence of sPOAF and to identify possible predictors in patients performing cardiovascular rehabilitation (CR) after CS. A single‐center cohort study was performed on 737 post‐surgical patients admitted to CR on sinus rhythm. Continuous monitoring with 12‐lead ECG telemetry was performed. We evaluated the predictive role of anamnestic, clinical, and laboratory data, including baseline NLR. Results Subacute POAF was documented in 170 cases (23.1%). At the multivariate analysis, age (OR 1.03; p = .001), mitral valve surgery (OR 1.77; p = .012), acute POAF (OR 2.97; p < .001), and NLR at baseline (OR 1.13; p = .042) were found to be independent predictive factors of sPOAF following heart surgery. Conclusions sPOAF is common after CS. Age, mitral valve procedures, acute POAF, and preoperative NLR were proved to increase sPOAF occurrence in CR. NLR is an affordable and reliable parameter which might be used to qualify the risk of arrhythmias at CR admission. Identification of new predictors of postoperative atrial fibrillation may allow to improve patients' prognosis. |
| format | Article |
| id | doaj-art-bfa5f35cbcae405b9c70e35657913b81 |
| institution | Kabale University |
| issn | 1880-4276 1883-2148 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj-art-bfa5f35cbcae405b9c70e35657913b812025-08-20T03:25:46ZengWileyJournal of Arrhythmia1880-42761883-21482024-02-01401677510.1002/joa3.12956Subacute postoperative atrial fibrillation after heart surgery: Incidence and predictive factors in cardiac rehabilitationVincenzo Rizza0Francesco Maranta1Lorenzo Cianfanelli2Iside Cartella3Francesco Maisano4Ottavio Alfieri5Domenico Cianflone6Vita‐Salute San Raffaele University Milan ItalyCardiac Rehabilitation Unit IRCCS San Raffaele Scientific Institute Milan ItalyCardiac Rehabilitation Unit IRCCS San Raffaele Scientific Institute Milan ItalySchool of Medicine and Surgery Milano‐Bicocca University Milan ItalyCardiac Surgery Unit IRCCS San Raffaele Scientific Institute Milan ItalyCardiac Surgery Unit IRCCS San Raffaele Scientific Institute Milan ItalyVita‐Salute San Raffaele University Milan ItalyAbstract Background Postoperative atrial fibrillation (POAF) is the most common arrhythmia following cardiac surgery (CS). It may occur between the 1st and the 4th postoperative day as acute POAF or between the 5th and the 30th as subacute (sPOAF). sPOAF is associated with higher thromboembolic risk, which consistently increase patients' morbidity. Neutrophil‐to‐lymphocyte ratio (NLR) is a low‐cost inflammatory index proposed as possible POAF predictor. Identification of patients' risk categories might lead to improved postoperative outcomes. Methods The aim was to assess the incidence of sPOAF and to identify possible predictors in patients performing cardiovascular rehabilitation (CR) after CS. A single‐center cohort study was performed on 737 post‐surgical patients admitted to CR on sinus rhythm. Continuous monitoring with 12‐lead ECG telemetry was performed. We evaluated the predictive role of anamnestic, clinical, and laboratory data, including baseline NLR. Results Subacute POAF was documented in 170 cases (23.1%). At the multivariate analysis, age (OR 1.03; p = .001), mitral valve surgery (OR 1.77; p = .012), acute POAF (OR 2.97; p < .001), and NLR at baseline (OR 1.13; p = .042) were found to be independent predictive factors of sPOAF following heart surgery. Conclusions sPOAF is common after CS. Age, mitral valve procedures, acute POAF, and preoperative NLR were proved to increase sPOAF occurrence in CR. NLR is an affordable and reliable parameter which might be used to qualify the risk of arrhythmias at CR admission. Identification of new predictors of postoperative atrial fibrillation may allow to improve patients' prognosis.https://doi.org/10.1002/joa3.12956atrial fibrillationcardiac rehabilitationcardiac surgeryneutrophil‐to‐lymphocyte ratiopostoperative complications |
| spellingShingle | Vincenzo Rizza Francesco Maranta Lorenzo Cianfanelli Iside Cartella Francesco Maisano Ottavio Alfieri Domenico Cianflone Subacute postoperative atrial fibrillation after heart surgery: Incidence and predictive factors in cardiac rehabilitation Journal of Arrhythmia atrial fibrillation cardiac rehabilitation cardiac surgery neutrophil‐to‐lymphocyte ratio postoperative complications |
| title | Subacute postoperative atrial fibrillation after heart surgery: Incidence and predictive factors in cardiac rehabilitation |
| title_full | Subacute postoperative atrial fibrillation after heart surgery: Incidence and predictive factors in cardiac rehabilitation |
| title_fullStr | Subacute postoperative atrial fibrillation after heart surgery: Incidence and predictive factors in cardiac rehabilitation |
| title_full_unstemmed | Subacute postoperative atrial fibrillation after heart surgery: Incidence and predictive factors in cardiac rehabilitation |
| title_short | Subacute postoperative atrial fibrillation after heart surgery: Incidence and predictive factors in cardiac rehabilitation |
| title_sort | subacute postoperative atrial fibrillation after heart surgery incidence and predictive factors in cardiac rehabilitation |
| topic | atrial fibrillation cardiac rehabilitation cardiac surgery neutrophil‐to‐lymphocyte ratio postoperative complications |
| url | https://doi.org/10.1002/joa3.12956 |
| work_keys_str_mv | AT vincenzorizza subacutepostoperativeatrialfibrillationafterheartsurgeryincidenceandpredictivefactorsincardiacrehabilitation AT francescomaranta subacutepostoperativeatrialfibrillationafterheartsurgeryincidenceandpredictivefactorsincardiacrehabilitation AT lorenzocianfanelli subacutepostoperativeatrialfibrillationafterheartsurgeryincidenceandpredictivefactorsincardiacrehabilitation AT isidecartella subacutepostoperativeatrialfibrillationafterheartsurgeryincidenceandpredictivefactorsincardiacrehabilitation AT francescomaisano subacutepostoperativeatrialfibrillationafterheartsurgeryincidenceandpredictivefactorsincardiacrehabilitation AT ottavioalfieri subacutepostoperativeatrialfibrillationafterheartsurgeryincidenceandpredictivefactorsincardiacrehabilitation AT domenicocianflone subacutepostoperativeatrialfibrillationafterheartsurgeryincidenceandpredictivefactorsincardiacrehabilitation |