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Postoperative atrial fibrillation in patients undergoing aortocoronary bypass surgery carries an eightfold risk of future atrial fibrillation and a doubled cardiovascular mortality
Abstract
OBJECTIVE: This article presents a study of postoperative atrial fibrillation (AF) and its long-term effects on mortality and heart rhythm. METHODS: The study cohort consisted of 571 patients with no history of AF who underwent primary aortocoronary bypass surgery from 1999 to 2000. Postoperative AF occurred in 165/571 patients (28.9%). After a median follow-up of 6 years, questionnaires were obtained from 91.6% of surviving patients and an electrocardiogram (ECG) from 88.6% of all patients. Data from hospitalisations due to arrhythmia or stroke during follow-up were analysed. The causes of death were obtained for deceased patients. RESULTS: In postoperative AF patients, 25.4% had atrial fibrillation at follow-up compared with 3.6% of patients with no AF at surgery (p<0.001). An episode of postoperative AF was the strongest independent risk factor for development of late AF, with an adjusted risk ratio of 8.31 (95% confidence interval (CI) 4.20-16.43). Mortality was 29.7% (49 deaths/165 patients) in the AF group and 14.8% (60 deaths/406 patients) in the non-AF group (p<0.001). Death due to cerebral ischaemia was more common in the postoperative AF group (4.2% vs 0.2%, p<0.001), as was death due to myocardial infarction (6.7% vs 3.0%, p=0.041). Postoperative AF was an age-independent risk factor for late mortality, with an adjusted hazard ratio of 1.57 (95% CI 1.05-2.34). CONCLUSIONS: Postoperative AF patients have an eightfold increased risk of developing AF in the future, and a doubled long-term cardiovascular mortality.
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“In the long term, patients with an episode of postoperative AF have a twofold increase in cardiovascular mortality and a substantially increased risk of future AF and ischaemic stroke compared with patients that remain in sinus rhythm after surgery.952-958”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [955]
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Metadata
- Authors
- Ahlsson, A., Fengsrud, E., Bodin, L., & Englund, A.
- Affiliations
- Örebro University Hospital (SE)
- Corresponding author
- Ahlsson, Anders
- Venue
- European Journal of Cardio-Thoracic Surgery
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-06
- Volume
- 37
- Issue
- 6
- Pages
- 1353-1359
- ISSN
- 1010-7940 (ISSN-L)
- OpenAlex
- W2144902508
- Cited by
- 259
- References
- 24
- Citations by year
- 2026: 11 · 2025: 22 · 2024: 28 · 2023: 17 · 2022: 26 · 2021: 22 · 2020: 27 · 2019: 21 · 2018: 15 · 2017: 17 · 2016: 9 · 2015: 9 · 2014: 15 · 2013: 9 · 2012: 7
- FWCI
- 4.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Cardio-Thoracic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- postoperative atrial fibrillation, coronary artery bypass grafting, cardiovascular mortality, stroke, myocardial infarction, risk factors, cardiac arrhythmias
- MeSH terms
- Aged, Coronary Artery Bypass, Atrial Fibrillation, Brain Ischemia, Electrocardiography, Epidemiologic Methods, Female, Humans, Male, Middle Aged, Myocardial Infarction, Prognosis, Recurrence, Stroke
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