Atrial fibrillation following elective open abdominal aortic aneurysm repair.
BACKGROUND
Atrial fibrillation is a common complication following major vascular surgery. It is often considered to be relatively benign but may represent the first sign of cardiac and non-cardiac complications. We conducted a retrospective study to determine the incidence and clinical associations of atrial fibrillation following open elective abdominal aortic aneurysm repair as well as its effect on prognosis.


METHODS
The case-notes of 200 consecutive patients undergoing open aneurysm repair were reviewed. Known pre-operative and intra-operative risk factors and potential post-operative associations with new-onset AF were recorded. Significant univariate correlates with AF were entered into a forward stepwise logistic regression model to test for independence. The effect of new-onset AF on long-term prognosis was assessed.


RESULTS
AF developed in 20 patients (10%) post-operatively. Previous cerebrovascular disease, aneurysm size and post-operative cardiac failure were associated with post-operative AF in univariate analyses. Cerebrovascular disease and post-operative cardiac failure were independently associated with new-onset AF. AF patients had a longer hospital stay. There was no difference in survival between those patients with and without new-onset AF.


CONCLUSIONS
New-onset AF is a common complication of open abdominal aortic aneurysm surgery and may indicate an underlying myocardial infarction. It is associated with a longer hospital stay and an increased risk of cardiac failure. Assessed and treated appropriately, it appears to have no effect on long-term prognosis.
Noorani
Ayesha
A
Cambridge Vascular Research Unit, Cambridge University Hospitals NHS Foundation Trust, Vascular Surgery, Addenbrooke's Hospital, Cambridge, United Kingdom. ayeshanoorani@yahoo.co.uk
Walsh
Stewart R
SR
Tang
Tjun Y
TY
Sadat
Umar
U
Cooper
David G
DG
Callaghan
Christopher J
CJ
Varty
Kevin
K
Gaunt
Michael E
ME
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000401:mortality / Q000601:surgery*; D001281:Atrial Fibrillation / Q000453:epidemiology*; D015331:Cohort Studies; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome