Predictors of Postoperative Atrial Fibrillation after Heart Valve Surgery

Document Type : Original Article

Abstract

Background- Atrial fibrillation (AF) is the most common complication after cardiac surgery and a
major cause of morbidity and increased cost of care. Suitable treatment and prevention of
postoperative AF are important for patients’ improved health and rehabilitation. This study
evaluates the risk factors of paroxysmal AF in patients who underwent valvular heart surgery.
Method- Between April and October 2006, 392 patients who underwent heart valve surgery at our
center were included in this prospective study. All relevant clinical, echocardiographic, and
laboratory data were gathered in all the patients.
Results- Postoperative AF occurred in 52 (13.3%) patients. In the univariate analysis, the presence
of aortic valve disease, mitral valve disease, dyslipidemia, preoperative digoxin consumption,
postoperative adrenergic use, intra-aortic balloon pump (IABP) insertion in post-surgery
intensive care unit, and large left atrium were significantly associated with the occurrence of
postoperative AF (all P<0.05). However, in the stepwise logistic regression model,
dyslipidemia (OR: 2.39, 95% CI: 1.12-5.09, P=0.020), left atrium dimension (OR: 0.12, 95%
CI: 0.76-0.28, P<0.001), IABP (OR: 7.10, 95% CI: 1.98-25.47, P=0.001), preoperative
digoxin use (OR: 2.55, 95% CI: 1.38-4.71, P=0.002), postoperative adrenergic use (OR:3.70,
95% CI: 1.77-7.73, P<0.001), aortic valve replacement (OR:0.38, 95% CI: 0.20-0.69,
P=0.0001), and mitral valve replacement (OR:3.53, 95% CI: 1.75-7.10, P<0.001) remained
independently predictive of postoperative AF.
Conclusions- The result of this study showed that dyslipidemia, left atrium dimension, mitral valve
replacement, aortic valve replacement, IABP, and adrenergic use in ICU and digoxin use
preoperatively were the independent predictors of AF after valvular surgery. Therefore, clinical
data and echocardiography may be useful in preoperative risk stratification of high-risk patients
for the occurrence of postoperative AF(Iranian Heart Journal 2008; 9 (2):10-17).

Keywords

Hossein Ali Bassiri MD, Khadijeh Ghanbarian MD, Majid Haghjoo MD*

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Iranian Heart Journal
Volume 9, Issue 2
June 2008
Pages 10-17

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