Predictive variables of atrial fibrillation in the postoperative period of cardiovascular surgery

Abstract

Atrial fibrillation (AF) is a frequent complication in the postoperative period (POP) of cardiovascular surgery (CVS). Its presence establishes worse evolution during hospitalization. Objectives: 1) To learn the characteristics and complications of patients with AF. 2) To identify variables that are associated with AF in the POP of CVS. Materials and Methods: A cohort study was carried out, which consecutively included patients in the POP of CVS from January 2017 to November 2019. AF was defined as the record by electrocardiogram longer than 5 minutes in the POP. The population was divided in two groups, according to absence (woAF) or presence of AF (wAF). Results: There were 305 cases included; AF was found in 23.3% (n=71). The incidence of this arrhythmia was higher in older patients (woAF 63 ±11 vs wAF 69 ±7 years; p<0.0001), obese (woAF 35% vs wAF 45%; p=0.05) and with dyslipidemia (woAF 47% vs wAF 62%; p=0.01). Valve surgeries had more AF episodes in the POP CVS (woAF 21% and wAF 32%; p=0,03). Multivariate analysis showed that age, valve surgery and dyslipidemia were independent predictors of AF in POP. During evolution, patients with AF had more stroke events, (woAF 0 vs wAF 7%; p<0.001) and greater need for inotropes (woAF 21% vs wAF 34%; p= 0.04) among other complications. Mortality in the woAF group was 9% (n=20) and wAF 7% (n = 5) p= 0.45. Conclusions: In our population, we found that 1 in 4 patients who underwent cardiac surgery developed AF, with age, valve surgery and dyslipidemia being the only independent predictor variables. During hospitalization, we observed more complications and worse evolution in patients with AF, with no difference in mortality.