title: Long-term consequences of atrial fibrillation after aortic valve replacement.
abstract: Background Atrial fibrillation is a common complication after cardiac surgery, but the risk factors and long-term outcome after primary isolated aortic valve replacement remains to be clarified. Methods A single-center retrospective study was conducted on 157 patients who underwent first-time isolated aortic valve replacement between April 1999 and February 2015. Fifty-eight patients developed new-onset atrial fibrillation within 6 months postoperatively, and they were compared with patients who remained in sinus rhythm. Multivariate analyses, which incorporated the propensity score patient matching technique, were conducted to evaluate the long-term outcome of new-onset postoperative atrial fibrillation and identify patients at risk of developing this arrhythmia. Results At a mean follow-up of 52.4 months (range 8.4-200.7 months), mortality was significantly higher in patients who developed atrial fibrillation compared to those who remained in sinus rhythm (2.8%/patient-year vs. 0.2%/patient-year, respectively; p < 0.05). Patients developing atrial fibrillation were also at an independently increased risk of stroke and readmission during follow-up. Risk analysis revealed that advanced age (>70 years) and absence of a postoperative β-blocker were predictors of atrial fibrillation. Conclusions New-onset atrial fibrillation after first-time isolated aortic valve replacement correlated significantly with late morbidity and mortality. Advanced age and absence of a postoperative β-blocker may increase the incidence of atrial fibrillation.
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kohno
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ueda
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Matsuura
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Yusaku
authors.initials: Y
authors.lastname: Tamura
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Goro
authors.initials: G
authors.lastname: Matsumiya
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D011183:Postoperative Complications; D057216:Propensity Score; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: Aortic valve; Atrial fibrillation; Follow-up studies; Heart valve prosthesis implantation; Postoperative complications; Risk factors