loading page

Atrial fibrillation after rheumatic heart valve surgery: Incidence, predictors and outcomes
  • +3
  • khalid ibrahim,
  • Khalid Kheirallah,
  • Fadia Mayyas,
  • Nizar ALwaqfi,
  • Nabil AlZoubi,
  • David R. Van Wagoner
khalid ibrahim
Jordan University of Science and Technology
Author Profile
Khalid Kheirallah
Jordan University of Science and Technology
Author Profile
Fadia Mayyas
Jordan University of Science and Technology
Author Profile
Nizar ALwaqfi
Jordan University of Science and Technology
Author Profile
Nabil AlZoubi
Jordan University of Science and Technology
Author Profile
David R. Van Wagoner
Cleveland Clinic Foundation
Author Profile

Abstract

Introduction: Atrial fibrillation after cardiac surgery (AFACS) impacts 10-65% of patients, depending on the complexity and trauma associated with the surgery. AFACS is associated with stroke and other systemic embolic manifestations. Methods: Patients at our hospital who underwent valve surgery procedures including aortic valve replacement (AVR), mitral valve replacement (MVR), AVR with coronary artery bypass grafting (CABG), MVR with CABG, or AVR and MVR with/without CABG were included in this study. Results: 346 patients were included in the current analysis, with a mean age of 51.6±16.1 years; 51% of patients were males. Univariate predictors of AF included age, gender, body mass index (BMI), operation type, ejection fraction (EF), left atrial (LA) diameter, previous history of AF, use of aldosterone antagonists > a month before surgery, use of loop diuretics > a month before surgery, length of ICU stay, total length of stay, cross clamp time > 90 minutes, pump time > 120 minutes, postoperative acute kidney injury, left ventricular systolic and diastolic end dimensions. By multivariate analysis, only age (P=0.028, AOR=10.6), male gender (P=0.021, AOR=3.398), type of surgery (P=0.034, AOR=7.12), history of AF (P=0.018, AOR=2.317), BMI (P<0.001, AOR=3.905), EF before surgery (P=<0.001, AOR=3.905), and LA diameter (P=0.0051, AOR=18.23) were found as independent predictors of AFACS. Conclusion: This study identifies risk factors associated with development of atrial fibrillation after rheumatic valve heart surgery. Older patients, male gender, type of surgery, preoperative AF, BMI, EF before surgery, and LA diameter are independent predictors of AF after cardiac valve surgery.