New-onset atrial fibrillation predicts long-term newly developed atrial fibrillation after coronary artery bypass graft

Abstract

New-onset postoperative atrial fibrillation (POAF) is associated with poor short- and long-term outcomes after isolated coronary artery bypass graft (CABG). The purpose of the present study is to test the hypothesis that new-onset POAF is independently associated with long-term (> 1 year) atrial fibrillation (AF) and mortality. Among 1,153 consecutive patients who had undergone CABG, AF and mortality were compared between patients with (POAF group, n=226) and without POAF (no-POAF group, n=927). Compared with no-POAF group, POAF group had higher incidence of short-term (10 days - 2 months; 0, vs. 4.4%, p<0.001), mid-term (3 month -1 year; 0.8, vs. 3.5%, p<0.001) and long-term AF (1.4, vs. 8.4%, p<0.001). During the follow-up period of 41 ± 23 months (range 0 to 87 months), the POAF group had lower cumulative survival free of long-term AF than the no-POAF group (p<0.001). In multivariate Cox regression, the predictors of long-term AF included POAF (OR 6.13, 95% CI 2.72-13.82, p < 0.001), chronic obstructive pulmonary disease (OR 6.38, 95% CI 1.76-23.19, p = 0.005) and renal failure (OR 6.62, 95% CI 2.40-18.28, p < 0.001). POAF group had higher short- and mid-term mortality than no-POAF group. However, the long-term mortality showed no difference between 2 groups. New-onset POAF was a predictor of long-term AF and related with short- and mid-term mortality in CABG patients. The results of this study suggested that patients who develop POAF should undergo strict surveillance and be routinely screened for AF during follow-up.