Risk-factors for AF in postop cardiac surgery patients

Q: Which ethnicity has a higher risk of postoperative atrial fibrillation after cardiac surgery? (select one)

A) Caucasian

B) Afro-American

C) Southeast Asian

D) Native Indian

Answer: A

Atrial fibrillation and atrial flutter are common in postoperative cardiac surgery patients. There are many risk factors described:

• age 
• Previous history
• mitral stenosis
• increased left atrial size 
• cardiomegaly
• any previous cardiac surgery
• COPD
• high preoperative hemoglobin A1c 
• caucasian race
• obesity 
• withdrawal of preoperative beta-blocker
• right coronary artery stenosis 
• electrolyte imbalance
• alcohol abuse

#surgical-critical-care

#cardiology

References:

1. Mathew JP, Fontes ML, Tudor IC, et al. A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA 2004; 291:1720.

2. Asher CR, Miller DP, Grimm RA, et al. Analysis of risk factors for development of atrial fibrillation early after cardiac valvular surgery. Am J Cardiol 1998; 82:892.

3. Zaman AG, Archbold RA, Helft G, et al. Atrial fibrillation after coronary artery bypass surgery: a model for preoperative risk stratification. Circulation 2000; 101:1403.

4. Deliargyris EN, Raymond RJ, Guzzo JA, et al. Preoperative factors predisposing to early postoperative atrial fibrillation after isolated coronary artery bypass grafting. Am J Cardiol 2000; 85:763.