Complications associated with the development of postoperative atrial fibrillation during heart surgery

Abstract

Introduction: a significant group of patients undergoing cardiac surgery develop postoperative atrial fibrillation. 40 % after coronary artery bypass grafting alone, 49 % after coronary artery bypass surgery plus aortic valve replacement, and 64 % after coronary artery bypass surgery plus mitral valve replacement. Determine the frequency of postoperative complications in the development of atrial fibrillation. The study included patients operated on at the Cardiac Surgery Department of the State Budgetary Healthcare Institution of Research Institute-KKB No. 1 of Krasnodar in the period from January 1, 2020 to January 1, 2021. During the analysed period of time, open-heart surgery was performed in 1503 patients, 158 of whom had newly diagnosed postoperative atrial fibrillation (10.5 %). Patients with postoperative atrial fibrillation were more likely to have ischaemic stroke, haemorrhagic complications, ventricular arrhythmias (ventricular fibrillation or flutter), and clinically significant atrioventricular block II and / or III degree, in addition, they had higher mortality in the early postoperative period (with index hospitalization), while acute myocardial infarction occurred with the same frequency in the compared groups. Thus, the relationship between postoperative atrial fibrillation and unfavourable early outcomes is significant, and therefore timely verification of arrhythmia and effective treatment of arrhythmia become relevant. Postoperative atrial fibrillationis a frequent complication of cardiac surgery, which worsens the short-term prognosis, and therefore it is necessary to identify patients at high risk of developing AFP. The appointment of anticoagulant therapy in patients with AFP remains a controversial issue and requires further study in a larger group of patients. It is important to note that AF after cardiac surgery increases the risk of intrahospital mortality, which requires an active search for predictors of this arrhythmia and the development of effective preventive strategies.