Cardiopulmonary bypass management and risk of new-onset atrial fibrillation after cardiac surgery.

• Cardiopulmonary bypass management may potentially play a role in the development of new-onset atrial fibrillation after cardiac surgery. The aim of this study was to explore this potential association.Patients who underwent coronary artery bypass grafting and/or valvular surgery during 2016-2020 were included in an observational single-centre study. Data collected from the SWEDEHEART Registry, and a local Cardiopulmonary bypass database were merged. Associations between individual cardiopulmonary bypass variables (Cardiopulmonary bypass and aortic clamp times, arterial and central venous pressure, mixed venous oxygen saturation, blood flow index, bladder temperature, and haematocrit) and new-onset atrial fibrillation were analysed using multivariable logistic regression models adjusted for patient characteristics, comorbidities, and surgical procedure.Out of 1,999 patients, 758 (37.9%) developed new-onset atrial fibrillation. Patients with new-onset postoperative atrial fibrillation were older, had a higher incidence of previous stroke, worse renal function and higher EuroSCORE II and CHA2DS2-VASc scores, and more often underwent valve surgery. Longer cardiopulmonary bypass time (adjusted odds ratio (aOR) 1.05 per 10min (95% confidence interval (CI) 1.01-1.08); p=0.008) and higher flow index (aOR 1.21 per 0.2L/m2 (95% CI 1.02-1.42); p=0.026) were associated with an increased risk for new-onset atrial fibrillation, while the other variables were not. A sensitivity analysis only including patients with isolated coronary artery bypass grafting supported the primary analyses.Cardiopulmonary bypass management following current guideline recommendations appears to have minor or no influence on the risk of developing new-onset atrial fibrillation after cardiac surgery.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

Cardiac surgery

Cardiopulmonary bypass

New-onset postoperative atrial fibrillation

Publication and Content Type

ref (subject category)

art (subject category)