Cardiothoracic & vascular anesthesia
Baseline Intraoperative Left Ventricular Diastolic Function Is Associated with Postoperative Atrial Fibrillation after Cardiac Surgery
Authors' conclusion
Baseline preoperative left ventricular diastolic dysfunction on TEE, not left atrial size or function, is independently associated with postoperative atrial fibrillation.
Study context
- Population
- PALACS cardiac surgery patients with available intraoperative transesophageal echocardiography (TEE) dataof 420
- Participants
- 402 patients
- Comparison
- Postoperative AF vs No postoperative AF
- Postoperative AFn = 99
- No postoperative AFn = 303reference
- Primary endpoint
- Association of intraoperative left atrial and left ventricular diastolic function (TEE) with postoperative AF
Methodological detailspost hoc analysis, cohort study
- Post hoc analysis
- Cohort study
Primary result
As reported in the abstract
Postoperative AF (independent associations, multivariable analysis)
Odds ratio (95% CI)P value
Baseline abnormal left ventricular diastolic function
2.02(1.15–3.63)
P = 0.016Pericardiotomy intervention
0.46(0.27–0.78)
P = 0.004Further findings
| Outcome | Postoperative AF | No postoperative AF | P value |
|---|---|---|---|
| Abnormal left ventricular diastolic function75.0% [n = 161 of 303] vs. 57.5% [n = 69 of 99], as printed | P = 0.004 | ||
| Delta left atrial area (presternotomy minus post-chest closure; univariate)Univariate analysis | 0.1 (IQR −4.0–4.8) | −2.1 (IQR −5.1–1.0) cm² | P = 0.028 |
Intraoperative diastolic dysfunction (prevalence)
- Patients with intraoperative diastolic dysfunction
- 230 of 402 patients (57.2%)
Postoperative AF incidence
- Patients developing postoperative AF
- 99 of 402 patients (24.6%)
Delta left atrial area (presternotomy minus post-chest closure; univariate)
- Only left atrial size/function parameter significantly different
Posterior pericardiotomy intervention by diastolic function
- Not significantly different between the two groups
Original publication
Baseline Intraoperative Left Ventricular Diastolic Function Is Associated with Postoperative Atrial Fibrillation after Cardiac Surgery. Anesthesiology. Published 8 August 2023. doi:10.
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