In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Predictors for new-onset post-operative atrial fibrillation in patients undergoing aortic valve replacement

Session Poster session 3

Speaker Associate Professor Luminita Iliuta

Event : ESC Congress 2014

  • Topic : arrhythmias and device therapy
  • Sub-topic : Atrial Fibrillation
  • Session type : Poster Session

Authors : L Iliuta (Bucharest,RO)

Authors:
L. Iliuta1 , 1University of Medicine and Pharmacy Carol Davila - Bucharest - Romania ,

Citation:
European Heart Journal ( 2014 ) 35 ( Abstract Supplement ), 427

Aim: 1. Defining the independent predictors for new-onset post-operative atrial fibrillation (POAF) in patients (pts) undergoing aortic valve replacement (AVR) and their adjusted value for calculation of a preoperative risk score.

2. Assessment of the independent prognostic value of the LV diastolic dysfunction and left atrium (LA) dilatation for POAF development in these pts.

3. Identifying the predictors for recurrent atrial fibrillation (AF) and their implications for postoperative course in AVR pts.

Material and method: Prospective study on 802 pts who underwent AVR for aortic stenosis (456pts) or aortic regurgitation (AR) (346pts). Patients were evaluated clinically and by echocardiography (including TDI) preoperatively and postoperatively at 10, 20 and 30 days. All were in sinus rhythm without history of AF.

Statistical analysis used SYSTAT and SPSS programs for regression analysis and for relative risks and correlation coefficient calculations. Multivariable analyses were adjusted for age and gender including left ventricular ejection fraction (LVEF)≤35%, restrictive LV diastolic filling pattern (LVDFP), renal insufficiency and logistic EuroSCORE ≥20%

Results: POAF occurred in 320 of 862 patients (39.9%).

1. Regression analysis identified as independent predictors for POAF: restrictive LVDFP (RR=23.42), preoperative AR (RR=10.31), LA dimension index >30mm/m2 (RR=13.92), advanced age (RR for 10-year increase=2.09), LVEF≤35%, LV endsystolic diameter (LVESD)>55mm, higher body mass index, NYHA class III/IV, comorbidities

2. The presence of a restrictive LVDFP increased the POAF risk by 23.42 fold and the rate of POAF increased exponentially with diastolic dysfunction severity (p<0.001)

3. Predictors of recurrent POAF (occurred at 44,69% of POAF pts) included restrictive LVDFP, age >75years, LA dimension index >30mm/m2, LV end-systolic volume (LVESV) >85cm3, bicaval venous cannulation, moderate mitral regurgitation (MR), severe pulmonary hypertension (PHT).

Conclusions: 1. The independent predictors for POAF initiation after AVR were: restrictive LVDFP, preoperative AR, advanced age, LVESD >55mm, LVEF ≤35%, obesity, NYHA class III/IV and comorbidities

2. Restrictive LVDFP and LA dilatation has a powerful independent and incremental predisposing value for the initiation of POAF after AVR and their evaluation may be very useful during risk stratification of patients undergoing cardiac surgery

3. The only independent predictors for recurrent POAF after AVR were: restrictive LVDFP, older age, LA dimension index>30mm/m2, LVESV>85cm3, bicaval venous cannulation, moderate MR, severe PHT.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are