Heart, lung & circulation · 2025
The Preoperative and Intraoperative Risk Factors With 1-Year Recurrence of New-Onset Paroxysmal Atrial Fibrillation After Thoracoscopic Surgery in Older Patients.
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Zhou Huiying, Han Yue, Liu Zijia, Zhang Yu, Zhang Yuelun, Shen Le
Аннотация
BACKGROUND: Postoperative atrial fibrillation (AF) after video-assisted thoracoscopic surgery (VATS) is the most prevalent form of secondary AF in older patients, which is likely to recur or even cause persistent AF and may receive long-term clinical treatment in clinically. We aimed to analyse the preoperative and intraoperative risk factors for the recurrence of paroxysmal postoperative AF.
METHOD: Data were collected from patients who underwent VATS and experienced paroxysmal postoperative AF at Peking Union Medical College Hospital between June 2013 and December 2022. We studied the incidence of AF recurrence within 1 year after initial occurrence and the potential preoperative and intraoperative risk factors using multivariable logistic regression analyses.
RESULTS: Of the 2,920 patients who underwent VATS in this study, 122 (4.2%) suffered paroxysmal postoperative AF within 30 days after surgery. The recurrence incidence of paroxysmal postoperative AF was 21.3% (26 of 122) within 1 year. Multiple logistic regression analysis revealed that left atrial diameter (odds ratio [OR] 1.13; 95% confidence interval [CI] 1.01-1.27; p=0.040), left ventricular ejection fraction (OR 0.91; 95% CI 0.83-0.98; p=0.013), and intraoperative hypotension (OR 5.04; 95% CI 1.20-21.69; p=0.025) were significant risk factors for paroxysmal postoperative AF recurrence.
CONCLUSIONS: Larger left atrial diameter, lower left ventricular ejection fraction, and intraoperative hypotension may be associated with AF recurrence in older patients with paroxysmal postoperative AF after thoracoscopic surgery. It could be helpful to identify patients at high risk of AF recurrence and advise active monitoring.
METHOD: Data were collected from patients who underwent VATS and experienced paroxysmal postoperative AF at Peking Union Medical College Hospital between June 2013 and December 2022. We studied the incidence of AF recurrence within 1 year after initial occurrence and the potential preoperative and intraoperative risk factors using multivariable logistic regression analyses.
RESULTS: Of the 2,920 patients who underwent VATS in this study, 122 (4.2%) suffered paroxysmal postoperative AF within 30 days after surgery. The recurrence incidence of paroxysmal postoperative AF was 21.3% (26 of 122) within 1 year. Multiple logistic regression analysis revealed that left atrial diameter (odds ratio [OR] 1.13; 95% confidence interval [CI] 1.01-1.27; p=0.040), left ventricular ejection fraction (OR 0.91; 95% CI 0.83-0.98; p=0.013), and intraoperative hypotension (OR 5.04; 95% CI 1.20-21.69; p=0.025) were significant risk factors for paroxysmal postoperative AF recurrence.
CONCLUSIONS: Larger left atrial diameter, lower left ventricular ejection fraction, and intraoperative hypotension may be associated with AF recurrence in older patients with paroxysmal postoperative AF after thoracoscopic surgery. It could be helpful to identify patients at high risk of AF recurrence and advise active monitoring.