Risk Factors for Postoperative Atrial Fibrillation in Myocardial Revascularization Surgery: A 15-Year Experience.

Background

Myocardial revascularization surgery (MRV) is a revascularization therapy for coronary artery disease aimed at improving survival conditions. Elderly patients with increased comorbidities undergoing MRV face challenges in preventing postoperative complications, including atrial fibrillation (AF), a common arrhythmia occurring in 40% of cases or even in 80% of cases if the procedure is combined with valve surgery. This study aimed to determine the risk factors associated with the appearance of postoperative AF (POAF) in patients undergoing isolated MRV.

Methods

This is an epidemiological, retrospective, and analytical case-control study (90 cases and 360 controls).

Results

Mortality within the group of patients who presented with POAF in the study population was 15.5%, and 9.44% in the control group. Logistic regression showed an association of AF with the presurgical variables age >60 years and urgent/emergency surgery and the postsurgical variables cardiogenic shock, blood transfusion, pulmonary edema, pleural effusion, orotracheal reintubation, and mechanical ventilation time.

Conclusions

Strategies should be proposed for the timely identification of risk factors and postoperative complications related to AF onset to avoid the increased morbidity and mortality associated with this type of arrhythmia during the postoperative period.