Forschung & Innovation
Publikationen
Preoperative interatrial block is associated with postoperative atrial fibrillation after cardiac surgery
PMU Autor*innen
Spela Leiler, Wolfgang Hitzl, Matthias Angerer, Theodor Fischlein, Jurij Matija Kalisnik
Alle Autor*innen
Spela Leiler, Andre Bauer, Wolfgang Hitzl, Rok Bernik, Valentin Guenzler, Matthias Angerer, Theodor Fischlein, Jurij Matija Kalisnik
Fachzeitschrift
Interdisciplinary Cardiovascular and Thoracic Surgery
Kurzfassung
OBJECTIVES: Atrial fibrillation is a common complication after heart surgery, potentially leading to chronic atrial fibrillation, heart failure and mortality. The aim of this study was to explore the relationship between preoperative interatrial block and the occurrence of postoperative atrial fibrillation. METHODS: Perioperative 12-channel electrocardiographies of patients in sinus rhythm scheduled for heart surgery, including bypass and/or valve surgery, were analysed. Patients with pre-existing atrial fibrillation, amiodarone therapy, atrioventricular block II or III, or pacemaker were excluded from the study. Clinical parameters in patients with versus without atrial fibrillation were compared. To evaluate the association between interatrial block and postoperative atrial fibrillation, univariable and multivariable regression analyses were performed. RESULTS: Out of 2374 patients, 1350 were amenable to analysis. Postoperative atrial fibrillation was documented in 505 (37.4%) patients. In multivariable regression analysis, prediction models with and without interatrial block were established. Step-wise regression analysis identified interatrial block [2.64 (2.02; 3.46), P < 0.001), age [1.11 (1.03; 1.20), P = 0.007], EuroScore II [1.05 (1.03; 1.07), P < 0.001], pulmonary hypertension [1.91 (1.24; 2.97), P = 0.006], history of cardiogenic shock [2.05 (1.11; 3.87), P = 0.032], statins [1.66 (1.21; 2.27), P = 0.002], chronic obstructive pulmonary disease [2.11 (1.25; 3.65), P = 0.009] and cardiopulmonary bypass time [1.78 (1.04; 3.05), P = 0.047] as independent predictors for postoperative atrial fibrillation. CONCLUSIONS: Preoperative interatrial block was associated with a higher incidence of postoperative atrial fibrillation. Inclusion of electrocardiography-derived preoperative conduction disturbances can enhance risk stratification of postoperative atrial fibrillation after heart surgery.
Keywords
ARRHYTHMIA, Atrial fibrillation, Interatrial block, Heart surgery