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High-Burden Premature Atrial Contractions Predict New-Onset Atrial Fibrillation After Surgical Septal Myectomy.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2023 Jun 15; Vol. 197, pp. 46-54. Date of Electronic Publication: 2023 May 05. - Publication Year :
- 2023
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Abstract
- Although increased premature atrial contractions (PACs) reportedly predict atrial fibrillation (AF) in both general and specific (e.g., patients with stroke) populations, early postoperative AF (POAF) risk in patients with increased PAC burden who require cardiac surgery remains unclear. We examined the correlation between different preoperative PAC burdens and POAF in patients with obstructive hypertrophic cardiomyopathy (OHCM) who underwent surgical treatment. We analyzed 304 consecutively admitted patients with OHCM without previous AF who underwent isolated septal myectomy between January 2015 and December 2018. All patients underwent preoperative 24-hour Holter electrocardiogram monitoring. PACs were present in 259 patients (85.20%) and absent in 45 patients (14.80%). According to the cut-off PAC number of 100 beats/24 hours, there were 211 patients (69.41%) with low-burden PACs and 48 patients (15.79%) with high-burden PACs. AF after septal myectomy occurred in 73 patients, which consisted of 3/45 in the non-PAC group (6.67%), 47/211 in the low-PAC-burden group (22.27%), and 23/48 in the high PAC burden group (47.92%). POAF incidence was higher in both low- and high-burden patients than in patients without PAC (p <0.01). Multivariate logistic regression analyses demonstrated that high-burden PACs (p = 0.02) and age (p <0.01) but not low-burden PACs (p = 0.22) independently predicted POAF in patients with OHCM. The area under the receiver operating characteristic curve for preoperative PACs was 0.72 (95% confidence interval 0.66 to 0.79, p <0.01, sensitivity: 68.49%, specificity: 69.26%). In conclusion, POAF incidence was significantly higher in patients with preoperative high-burden PACs and can predict POAF in patients with OHCM.<br />Competing Interests: Disclosures The authors have no conflicts of interest to declare.<br /> (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Coronary Artery Bypass adverse effects
Electrocardiography, Ambulatory
Risk Factors
Atrial Fibrillation diagnosis
Atrial Fibrillation epidemiology
Atrial Fibrillation etiology
Atrial Premature Complexes diagnosis
Atrial Premature Complexes epidemiology
Atrial Premature Complexes complications
Cardiac Surgical Procedures adverse effects
Cardiomyopathy, Hypertrophic diagnosis
Cardiomyopathy, Hypertrophic epidemiology
Cardiomyopathy, Hypertrophic surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 197
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 37150025
- Full Text :
- https://doi.org/10.1016/j.amjcard.2023.03.033