Atrial fibrillation after rheumatic heart valve surgery: Incidence, predictors and outcomes

Introduction: Atrial fibrillation after cardiac surgery (AFACS) impacts 10-65% of patients, depending on the complexity and trauma associated with the surgery. AFACS is associated with stroke and other systemic embolic manifestations. Methods: Patients at our hospital who underwent valve surgery procedures including aortic valve replacement (AVR), mitral valve replacement (MVR), AVR with coronary artery bypass grafting (CABG), MVR with CABG, or AVR and MVR with/without CABG were included in this study. Results: 346 patients were included in the current analysis, with a mean age of 51.6±16.1 years; 51% of patients were males. Univariate predictors of AF included age, gender, body mass index (BMI), operation type, ejection fraction (EF), left atrial (LA) diameter, previous history of AF, use of aldosterone antagonists > a month before surgery, use of loop diuretics > a month before surgery, length of ICU stay, total length of stay, cross clamp time > 90 minutes, pump time > 120 minutes, postoperative acute kidney injury, left ventricular systolic and diastolic end dimensions. By multivariate analysis, only age (P=0.028, AOR=10.6), male gender (P=0.021, AOR=3.398), type of surgery (P=0.034, AOR=7.12), history of AF (P=0.018, AOR=2.317), BMI (P