Prediction and incidence of atrial fibrillation after aortic arch repair

Background. Although atrial fibrillation is often associated with increased morbidity after open heart surgery, neither the incidence nor the clinical consequences of atrial fibrillation after aortic surgery has been well investigated. The goal of this study was to elucidate the risks for incidence of postoperative atrial fibrillation after aortic arch repair. Methods. From January 1993 to February 2004, 483 patients with atherosclerotic aortic arch aneurysm (n = 327) or aortic dissection (n = 156) underwent total aortic arch repair. All patients operated on as elective, urgent, or emergency aortic arch repair were included. One hundred sixteen patients received surgery on an emergency basis because of rupture or acute type A dissection. Twenty-four patients had atrial fibrillation preoperatively. Potential predictors of postoperative atrial fibrillation were estimated by a logistic regression model. Results. The incidence of postoperative, new onset of atrial fibrillation was 52.7% (242 of 459). The length of postoperative hospital stay was longer in patients with postoperative atrial fibrillation (48 ± 52 days) than in patients without it (35 ± 29 days; p = 0.001). The length of intensive care unit stay was also longer in patients with postoperative atrial fibrillation (12.1 ± 23.2) than in patients without it (6.2 ± 8.8; p = 0.002). Advanced age (p = 0.007; odds ratio = 1.34; 95% confidence interval: 1.14 to 1.62, per 10 years) was the only risk factor that correlated with postoperative new onset of atrial fibrillation. Conclusions. Atrial fibrillation was not uncommon after aortic arch repair. Advanced age was the only preoperative risk factor for postoperative atrial fibrillation.