Abstract 3234: New-onset Post-operative Atrial Fibrillation Following Aortic Valve Replacement Surgery and Long-term Survival
Background: Atrial fibrillation (AFIB) is a common complication of open cardiac surgery, occurring in up to 65% of patients. The advancing age and increasing risk profile of patients receiving aortic valve replacement (AVR) is expected to raise incidence of new-onset post-operative AFIB. During the early postoperative course, new-onset post-AVR AFIB is considered a relatively minor complication and is generally thought to have little impact on patients’ outcomes. However, the effect of new-onset post-AVR AFIB on long-term survival is unclear.
Methods: Survival was assessed in 1,150 consecutive patients without preoperative AFIB who underwent AVR at Baylor University Medical Center, Dallas, TX between 1/1/97–12/31/06 -patients who died during surgery were excluded.
Results: Ten-year unadjusted survival was 49.6% [40.1%, 58.5%] for patients with new-onset post-operative AFIB and 59.1% [48.8%, 68.0%] for patients without. The association between new-onset post-AVR AFIB and long-term survival was investigated using a propensity-adjusted model controlling for risk factors identified by the Society of Thoracic Surgeons and other clinical/non-clinical details. After adjustment, new-onset AFIB was significantly associated (Hazard Ratio: 1.42; 95%CI: 1.09, 1.84) with increased risk of death.
Conclusions: This study indicates that new-onset post-AVR AFIB is significantly associated with increased long-term risk of mortality independent of pre-operative risk profile. After controlling for a comprehensive array of risk factors associated with post-AVR adverse outcomes, development of new-onset post-AVR AFIB resulted in a 42% higher risk of long-term mortality.