Prevalence of postoperative atrial fibrillation and its effect on the cardiac rehabilitation

█ Original article

DOI: 10.26430/CHUNGARICA.2024.54.1.18

Authors:
Szuromi Lilla, Szegedi Andrea, Csanádi Zoltán, Homoródi Nóra
Debreceni Egyetem, Klinika Központ, Kardiológiai és Szívsebészeti Klinika, Kardiológiai Rehabilitációs Osztály, Debrecen

Summary

Introduction: Postoperative atrial fibrillation is one of the most common arrhythmias after cardiac surgery. It prolongs inpatient hospitalisation and increases the costs of hospital care as well as early and late mortality.
Our study aimed to characterize the prevalence, predictors and recurrence of postoperative atrial fibrillation and the effect of arrhythmia on the early cardiac rehabilitation after coronary, valve or combined surgery.
Methods: All patients were treated at our Cardiac Rehabilitation Department between January 2016 and December 2017. Patients with new onset atrial fibrillation were compared with the arrhythmia-free group. Predictors of the postope-rative atrial fibrillation, the clinical parameters, the aerobic capacity and endurance of the patients were characterized during the cardiac rehabilitation. Patients were followed up via transtelephonic ECG.
Results: A total of 289 patients (103 women; age 64.2 [±10.1] years) were included in the study, in 117 (40.5%) patients developed new onset atrial fibrillation. In this group, significantly higher age, CHA₂DS₂-VASc Score, pre- and postope-rative left atrial diameters, worse pre- and postoperative renal function and lower haemoglobin levels were identified. Further decrease of renal function (73.4 [±16.7] ml/min/1.73 m² vs. 67.9 [±19.4] ml/min/1.73 m²; p<0.0001) and decreased aerobic capacity and endurance at the beginning (247.7 m [±120] vs. 281.9 m [±111.8]; p=0.030) and at the end of rehabilitation (323.8 m [±119.5] vs. 367.5 m [±105.6]; p=0.009) were admitted. At discharge, transtelephonic ECG system was given in 39 cases (32%), atrial fibrillation was recorded in 5 patients (12.8%).
Conclusions: Postoperative atrial fibrillation is significantly more prevalent in patients with higher age, decreased renal function, greater left atrial diameter and lower postoperative haemoglobin level. During the early cardiac rehabilitation, in patients with atrial fibrillation further decrease of renal function, decreased aerobic capacity and endurance were admitted compared with the control group. The arrhythmia recurrence rate was 12.8% during the 3-weeks follow-up.

ISSUE: CARDIOLOGIA HUNGARICA | 2024 | VOLUME 54, ISSUE 1

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