Long-Term Effects of Postoperative Atrial Fibrillation following Mitral Valve Surgery

• Published in: Journal of cardiovascular development and disease 2023-07, Vol.10 (7), p.302
• Main Authors: Alghosoon, Haneen, Arafat, Amr A, Albabtain, Monirah A, Alsubaie, Faisal F, Alangari, Abdulaziz S
• Format: Article
• Language: English
• Subjects: Analysis; Anti-arrhythmia drugs; Atrial fibrillation; Cardiac arrhythmia; Data collection; Diabetes; Extracorporeal membrane oxygenation; Health aspects; Heart; Heart failure; Heart surgery; Heart valve diseases; Hemodialysis; Hospitals; Hypertension; Lung diseases; Medical research; Medicine, Experimental; mitral valve repair; mitral valve replacement; Mortality; Patients; postoperative atrial fibrillation; Saudi Arabia; short- and long-term outcomes; Statistical analysis; Stroke; Surgery; Ventilators
• ISSN: 2308-3425; 2308-3425
• DOI: 10.3390/jcdd10070302

New-onset postoperative atrial fibrillation (PoAF) is one of the most frequent yet serious complications following cardiac surgery. Long-term consequences have not been thoroughly investigated, and studies have included different cardiac operations. The objectives were to report the incidence and short- and long-term outcomes in patients with PoAF after mitral valve surgery. This is a retrospective cohort study of 1401 patients who underwent mitral valve surgery from 2009 to 2020. Patients were grouped according to the occurrence of PoAF ( = 236) and the nonoccurrence of PoAF ( = 1165). Long-term outcomes included mortality, heart failure rehospitalization, stroke, and mitral valve reinterventions. The overall incidence of PoAF was 16.8%. PoAF was associated with higher rates of operative mortality (8.9% vs. 3.3%, < 0.001), stroke (6.9% vs. 1.5%, < 0.001), and dialysis (13.6% vs. 3.5%, < 0.001). ICU and hospital stays were significantly longer in patients with PoAF ( < 0.001 for both). PoAF was significantly associated with an increased risk of mortality [HR: 1.613 (95% CI: 1.048-2.483); = 0.03], heart failure rehospitalization [HR: 2.156 (95% CI: 1.276-3.642); = 0.004], and stroke [HR: 2.722 (95% CI: 1.321-5.607); = 0.007]. However, PoAF was not associated with increased mitral valve reinterventions [HR: 0.938 (95% CI: 0.422-2.087); = 0.875]. Atrial fibrillation after mitral valve surgery is a common complication, with an increased risk of operative mortality. PoAF was associated with lower long-term survival, increased heart failure rehospitalization, and stroke risk. Future studies are needed to evaluate strategies that can be implemented to improve the outcomes of these patients.