Abstract
Introduction:
Atrial fibrillation (AF) after cardiac surgery occurs in 20%–40% of cases and is associated with significant morbidity. Studies have shown an association with immediate postoperative AF (POAF) and recurrent AF; however, to our knowledge, no trials have used continuous electrogram monitoring data from cardiac devices (pacemakers or defibrillators) to assess the rate of long-term AF recurrence.
Methods:
Using institutional databases, we identified patients with a cardiac device who underwent coronary artery bypass grafting (CABG) and/or a procedure on their aortic valve (AV) or mitral valve (MV) between January 2011 and March 2020. POAF and comorbidities were assessed using the electronic patient record, and recurrent device-detected AF was defined as any episode of AF lasting >6 min on device check between 6 weeks and 18 months postoperatively.
Results:
POAF was associated with recurrent device-detected AF (n = 85, odds ratio 3.26, 95% confidence interval 1.19–8.97, p = 0.02). Age was an independent risk factor for developing POAF (n = 302, p = 0.033), and MV surgery had a higher rate of POAF than CABG alone (54% vs. 32%, p = 0.047) and AV surgery (54% vs. 34%, p = 0.048). Forty-four per cent of patients developing POAF were discharged on oral anticoagulation (OAC).
Discussion:
Postoperative is associated with a threefold greater odds of developing recurrent device-detected AF: it is not a simple transient phenomenon. Larger prospective studies are required to identify which patients would benefit from heart rhythm surveillance and whether OAC is an effective treatment in this patient group.
Atrial fibrillation (AF) after cardiac surgery occurs in 20%–40% of cases and is associated with significant morbidity. Studies have shown an association with immediate postoperative AF (POAF) and recurrent AF; however, to our knowledge, no trials have used continuous electrogram monitoring data from cardiac devices (pacemakers or defibrillators) to assess the rate of long-term AF recurrence.
Methods:
Using institutional databases, we identified patients with a cardiac device who underwent coronary artery bypass grafting (CABG) and/or a procedure on their aortic valve (AV) or mitral valve (MV) between January 2011 and March 2020. POAF and comorbidities were assessed using the electronic patient record, and recurrent device-detected AF was defined as any episode of AF lasting >6 min on device check between 6 weeks and 18 months postoperatively.
Results:
POAF was associated with recurrent device-detected AF (n = 85, odds ratio 3.26, 95% confidence interval 1.19–8.97, p = 0.02). Age was an independent risk factor for developing POAF (n = 302, p = 0.033), and MV surgery had a higher rate of POAF than CABG alone (54% vs. 32%, p = 0.047) and AV surgery (54% vs. 34%, p = 0.048). Forty-four per cent of patients developing POAF were discharged on oral anticoagulation (OAC).
Discussion:
Postoperative is associated with a threefold greater odds of developing recurrent device-detected AF: it is not a simple transient phenomenon. Larger prospective studies are required to identify which patients would benefit from heart rhythm surveillance and whether OAC is an effective treatment in this patient group.
| Original language | English |
|---|---|
| Article number | 1669461 |
| Number of pages | 9 |
| Journal | Frontiers in Cardiovascular Medicine |
| Volume | 12 |
| DOIs | |
| Publication status | Published - 3 Oct 2025 |
Bibliographical note
Publisher Copyright:2025 Swinn, Pezard-Snell, Brain, Dimitropoulos, Dastidar, Sammut and Barman.
Keywords
- device-detected AF
- AF
- atrial fibrillation
- subclinical
- cardiac surgery