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Perioperative Atrial Fibrillation in Noncardiac Surgeries for Malignancies and One-Year Recurrence

2019; Elsevier BV; Volume: 35; Issue: 11 Linguagem: Inglês

10.1016/j.cjca.2019.07.008

1916-7075

Satoshi Higuchi, Yusuke Kabeya, Kenichi Matsushita, Nobuaki Arai, Keisei Tachibana, Ryota Tanaka, Riken Kawachi, Hidefumi Takei, Yutaka Suzuki, Masaharu Kogure, Yorihisa Imanishi, Kiyoshi Moriyama, Masanori Sugiyama, Tomoko Yorozu, Koichiro Saito, Nobutsugu Abe, Haruhiko Kondo, Hideaki Yoshino,

Coronary Interventions and Diagnostics

Background Perioperative atrial fibrillation (POAF) in noncardiac surgeries is common. However, it is unclear whether such atrial fibrillation (AF) recurs in the long term. Methods This study was a prospective, single-center, observational study that included patients who underwent noncardiac surgeries for malignancies. Patients were followed up for 1 year to evaluate the incidence of AF, ischemic stroke, and mortality. An event-triggered recorder was used in patients with POAF. The incidences were compared according to the presence of POAF. Results Of 752 consecutive patients, 77 (10.2%) developed POAF and wore an event recorder for 19 (12-30) days. AF and ischemic stroke at 1 year were observed in 24 patients (31.1%) and 2 patients (2.6%) with POAF and 4 patients (0.6%) and 3 patients (0.4%) without POAF, respectively. Of the 24 patients with POAF and AF recurrence, 22 (92%) were asymptomatic. Anticoagulation was prescribed in 67 patients (87%) with POAF. Multivariate Cox regression analysis demonstrated that a higher AF recurrence rate in patients with POAF was associated with hypertension (hazard ratio, 2.79; 95% confidence interval, 1.06-7.38) and serum creatinine level (hazard ratio for 20 μmol/L increase, 2.32; 95% confidence interval, 1.16-4.62). Conclusions AF recurs in approximately 30% of patients with POAF with malignancy in the subsequent year; most recurrences are asymptomatic.