Satoshi Higuchi1, Yusuke Kabeya2, Kenichi Matsushita3, Nobuaki Arai4, Keisei Tachibana4, Ryota Tanaka4, Riken Kawachi5, Hidefumi Takei6, Yutaka Suzuki7, Masaharu Kogure7, Yorihisa Imanishi8, Kiyoshi Moriyama9, Masanori Sugiyama7, Tomoko Yorozu9, Koichiro Saito10, Nobutsugu Abe7, Haruhiko Kondo4, Hideaki Yoshino3. 1. Department of Cardiology, Kyorin University School of Medicine, Tokyo, Japan; Department of Emergency and General Medicine, Kyorin University School of Medicine, Tokyo, Japan. Electronic address: sahiguchi-circ@umin.ac.jp. 2. Division of General Internal Medicine, Department of Internal Medicine, Tokai University, Kanagawa, Japan; Department of Home Care Medicine, Sowa Hospital, Kanagawa, Japan. 3. Department of Cardiology, Kyorin University School of Medicine, Tokyo, Japan. 4. Department of General Thoracic Surgery, Kyorin University School of Medicine, Tokyo, Japan. 5. Department of General Thoracic Surgery, Nihon University School of Medicine, Tokyo, Japan. 6. Department of General Thoracic Surgery, Kyorin University School of Medicine, Tokyo, Japan; Division of Chest Surgery, Showa University School of Medicine, Tokyo, Japan. 7. Department of Surgery, Kyorin University School of Medicine, Tokyo, Japan. 8. Department of Otorhinolaryngology, Head and Neck Surgery, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Japan. 9. Department of Anesthesiology, Kyorin University School of Medicine, Tokyo, Japan. 10. Department of Otolaryngology-Head and Neck Surgery, Kyorin University School of Medicine, Tokyo, Japan.
Abstract
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.
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.
Authors: David Amar; Hao Zhang; Mina K Chung; Kay See Tan; Dawn Desiderio; Bernard J Park; Alessia Pedoto; Nancy Roistacher; James M Isbell; Daniela Molena; Ginger L Milne; Bryan F Meyers; Gregory W Fischer; Valerie W Rusch; David R Jones Journal: Anesthesiology Date: 2022-06-01 Impact factor: 7.892
Authors: Nicole Lowres; Graham S Hillis; Marc A Gladman; Mark Kol; Jim Rogers; Vincent Chow; Ferris Touma; Cara Barnes; Joanne Auston; Ben Freedman Journal: Int J Cardiol Heart Vasc Date: 2020-06-29
Authors: Jessica T Huynh; Jeff S Healey; Kevin J Um; Maria E Vadakken; Anand S Rai; David Conen; Pascal Meyre; Jawad H Butt; Hooman Kamel; Seleman J Reza; Stephanie T Nguyen; Zardasht Oqab; P J Devereaux; Kumar Balasubramanian; Alexander P Benz; Emilie P Belley-Cote; William F McIntyre Journal: CJC Open Date: 2021-01-12