Evaluation of Post-Operative Atrial Fibrillation after Cardiac Surgery for Adult Congenital Heart Disease  

作　　者：Jonathan S.Taylor-Fishwick Nicholas Holzemer Brandon Middlemist Vivian Duarte Kaitlin E.Olson Johannes Cvon Alvensleben Megan SooHoo Amber Khanna 

机构地区：[1]Internal Medicine-Pediatrics Residency,University of Colorado,Aurora,CO 80045,USA [2]Adult Congenital Heart Disease Fellowship,University of Colorado,Aurora,CO 80045,USA [3]School of Medicine,University of Colorado,Aurora,CO 80045,USA [4]Department of Pediatrics,University of Colorado,Aurora,CO 80045,USA [5]Division of Pediatric Cardiology,Electrophysiology,University of Colorado,Aurora,CO 80045,USA [6]Division of Pediatric Cardiology,University of Colorado,Aurora,CO 80045,USA [7]Division of Cardiology,University of Colorado,Aurora,CO 80045,USA

出　　处：《Congenital Heart Disease》2024年第5期457-472,共16页先天性心脏病（英文）

摘　　要：Background:Post-operative atrial fibrillation(POAF)frequently occurs after cardiac surgery.Although adult congenital heart disease(ACHD)patients have higher rates of arrhythmia than the general population,there is scant literature on POAF in ACHD patients.Objectives:Identify key risk factors associated with post-operative atrial fibrillation and evaluate the short-and mid-term significance of developing POAF.Methods:A retrospective cohort study was conducted of ACHD patients from 2013–2021 at the University of Colorado Hospital and Children’s Hospital of Colorado.The institutional Society of Thoracic Surgeons(STS)surgical registry was used to identify patients≥18-year-old with congenital heart disease who underwent cardiac surgery during the study period.Results:A total of 168 patients(48%female)were included.The median age was 36 years(IQR 28–48).Onehundred and fifty patients(90%)had moderate ACHD anatomical complexity,and 10 patients(6%)had severe ACHD anatomical complexity based on initial ACHD diagnosis.POAF occurred in 40(24%)patients.Older age,history of supraventricular tachycardia,intra-operative arrhythmia,and post-operative hypokalemia independently predicted POAF.POAF was associated with an increased length of stay(8 vs.5 days,p<0.001)and recurrence of atrial fibrillation(46%vs.21%,OR 3.35,p=0.002)but did not predict mortality,stroke,or bleeding event.Conclusion:Atrial fibrillation is a common complication after cardiac surgery in the ACHD population.Older age,history of supraventricular tachycardia,intra-operative arrhythmia,and post-operative hypokalemia independently predicted POAF.Further investigation is needed to understand the long-term impacts of POAF.

关 键 词：Atrial fibrillation adult congenital heart disease cardiac surgery post-operative complications 

分 类 号：R541.75[医药卫生—心血管疾病]