title: Atrial fibrillation after cardiac surgery: incidence, risk factors, and economic burden.
abstract: OBJECTIVE
  To evaluate the incidence of postoperative atrial fibrillation (POAF), the predisposing factors, the results of treatment before discharge, and the impact on duration and costs of hospitalization.
  
  
  METHODS
  A prospective observational study.
  
  
  METHODS
  Patients who underwent cardiac surgery from January 1, 2007 to December 31, 2007.
  
  
  METHODS
  Electrocardiography was continuously monitored after surgery. Patients with symptomatic new-onset atrial fibrillation or lasting >15 minutes were treated with amiodarone and with DC shock in prolonged cases.
  
  
  RESULTS
  POAF occurred in 29.7%, with the higher incidence between the 1st and 4th postoperative day. Age (p < 0.001), atrial size >40 mm (p < 0.001), previous episodes of AF (p < 0.001), female sex (p = 0.010), and combined valve and bypass surgery (p = 0.012) were multivariate predictors of POAF at logistic regression. Sinus rhythm was restored by early treatment in 205 of 215 patients. This was associated with a low incidence of cerebrovascular events (<0.5%) and with a limited increase of average length of hospitalization (24 hours) in patients with POAF.
  
  
  CONCLUSIONS
  The overall incidence of POAF in the authors' center is close to 30%; 95.3% of patients were discharged in sinus rhythm. The increase in length and costs of hospitalization (on average, 1.0 day with a burden of about €1,800/patient) were significantly lower than in previous investigations.
authors.affiliation: Department Critical Area, University of Florence, Florence, Italy. c.rostagno@katamail.com
authors.forename: Carlo
authors.initials: C
authors.lastname: Rostagno
authors.forename: Mark
authors.initials: M
authors.lastname: La Meir
authors.forename: Sandro
authors.initials: S
authors.lastname: Gelsomino
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ghilli
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rossi
authors.forename: Enrico
authors.initials: E
authors.lastname: Carone
authors.forename: Lucio
authors.initials: L
authors.lastname: Braconi
authors.forename: Gabriele
authors.initials: G
authors.lastname: Rosso
authors.forename: Francesco
authors.initials: F
authors.lastname: Puggelli
authors.forename: Alessio
authors.initials: A
authors.lastname: Mattesini
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Stefàno
authors.forename: Luigi
authors.initials: L
authors.lastname: Padeletti
authors.forename: Jos
authors.initials: J
authors.lastname: Maessen
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
mesh_terms: D000367:Age Factors; D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000191:economics* / Q000453:epidemiology* / Q000628:therapy; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000191:economics*; D015984:Causality; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D004452:Echocardiography; D004599:Electric Stimulation Therapy; D004562:Electrocardiography; D023381:Endpoint Determination; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000191:economics* / Q000453:epidemiology* / Q000628:therapy; D012307:Risk Factors
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone