Arrhythmias & electrophysiology
Clinical Predictors of Device-Detected Atrial Fibrillation During 2.5 Years After Cardiac Surgery: Prospective RACE V Cohort
Authors' conclusion
In patients with and without AF history, late-POAF recurrences are frequent, including in patients undergoing surgical AF ablation. In patients with no history of AF, late-POAF might be predicted with excellent accuracy by using a combination of preoperative variables. In patients with a history of AF, signs of advanced AF substrate (eg, increased right atrial volumes) were associated with long-term AF recurrences.
Study context
- Population
- Patients undergoing cardiac surgery, continuously monitored with an implantable loop recorder for 2.5 years
- Participants
- 133 patients
- Exposure
- No preoperative atrial fibrillation (AF) vs Preoperative AF
- No preoperative AFn = 87
- Preoperative AFn = 33
- Outcome
- Device-detected postoperative atrial fibrillation (POAF) incidence (early-POAF within 90 days; late-POAF after 90 days) and its clinical predictors
- Follow-up
- 2.5 years after surgery
Methodological detailsconsecutive patients, implantable loop recorder monitoring
- Consecutive patients
- Implantable loop recorder monitoring
Main finding
As reported in the abstract
Device-detected POAF
| Group | Value | Early-POAF (first 90 days) | Late-POAF (after 90 days) | Late-POAF with prior early-POAF | Late-POAF recurrences |
|---|---|---|---|---|---|
| No preoperative AF | 47.1% | 41 (47.1%) of 87 | 22 (25%) of 87 | 20 of 22 [91%] | |
| Preoperative AF | 67% | 22 of 33 [67%] |
Value
No preoperative AF47.1%
Preoperative AF67%
Early-POAF (first 90 days)
No preoperative AF41 (47.1%) of 87
Preoperative AFNot reported in the abstract
Late-POAF (after 90 days)
No preoperative AF22 (25%) of 87
Preoperative AFNot reported in the abstract
Late-POAF with prior early-POAF
No preoperative AF20 of 22 [91%]
Preoperative AFNot reported in the abstract
Late-POAF recurrences
No preoperative AFNot reported in the abstract
Preoperative AF22 of 33 [67%]
- Prediction model for late-POAF (RAVImin >11 mL/m², age >65 years, early-POAF), AUC
- 0.82 (95% CI 0.72-0.92)
Observational data: associations, not effects.
Original publication
Clinical Predictors of Device-Detected Atrial Fibrillation During 2.5 Years After Cardiac Surgery: Prospective RACE V Cohort. JACC Clin Electrophysiol. Published 13 March 2024. doi:10.
Summarised from the published abstract; every number is checked against it