Abstract 17514: Differences in Risk of Long Term Atrial Fibrillation and Ischemic Stroke Between Post-operative Atrial Fibrillation After Cardiac and Non-cardiac Surgeries
Background: New onset post-operative atrial fibrillation (POAF) occurs after both non-cardiac and cardiac surgeries. Comparative differences in long term outcomes between these types of surgeries is however unknown.
Methods: A single-center,retrospective study was performed from January 2010 to April 2014 at the University of Arkansas for Medical Sciences. All patients who suffered from post-operative atrial fibrillation (AF) were identified using CPT codes. Patients with a prior history of AF, who were on anti-arrhythmic drugs pre-operatively,or those who remained in AF at discharge were excluded. Sinus rhythm was achieved in all patients with a combination of intravenous and oral amiodarone. Oral amiodarone was continued for a month after discharge. Recurrence of AF was identified by chart and ECG review. Ischemic stroke after discharge was identified by review of the electronic medical record.
Results: 81 patients (46 cardiac; 35 non-cardiac) were included. Mean follow up was 1750 days. AF recurred in 15.9 % and was more common in those with POAF after cardiac surgery, though the difference was not statistically significant (21% vs 5.5%, Figure 1a). Despite similar mean CHA2DS2VASc scores at baseline (2.7), ischemic stroke was more common in patients with POAF after cardiac surgery compared to non-cardiac surgery (12.5% vs 0%, Figure 1b).
Conclusion: Despite achieving sinus rhythm with anti-arrhythmic drugs, there is a significant risk of long term recurrence of AF and stroke among patients with new onset POAF. The risk of these events was higher after cardiac POAF, but the difference was not statistically significant. This was likely due to the small size of the cohort .These preliminary results should be verified prospectively in a larger cohort.
Author Disclosures: K. Ayoub: None. J. Xu: None. F. Habash: None. A. Almomani: None. A. Shaw-Devine: None. H. Paydak: None. S. Vallurupalli: None.
- © 2016 by American Heart Association, Inc.