Valvular surgery is associated with an increased risk of post-operative atrial fibrillation: secondary analysis of the SEARCH-AF CardioLink-1 randomized trial

Abstract Background Patients undergoing valve surgery have a higher risk of developing post-operative atrial fibrillation (POAF) relative to those isolated coronary artery bypass grafting (CABG). Whether this extends beyond hospital discharge is unknown. Purpose We examined the association between type (isolated CABG vs. repair/replacement) on incidence by conducting secondary analysis Post-Surgical Enhanced Monitoring for Cardiac Arrhythmias and Atrial Fibrillation (SEARCH-AF) CardioLink-1 randomized trial. Methods In SEARCH-AF trial, 336 patients with factors stroke (CHA2DS2-VASc score ≥2) no history preoperative AF were usual care or continuous cardiac rhythm monitoring 30 days after from wearable, patched-based device. The primary outcome was occurrence cumulative fibrillation/flutter (AF/AFL) lasting ≥6 minutes detected AF/AFL documented 12-lead ECG within randomization. compared POAF who underwent repair/replacement. experienced during hospitalization excluded analysis. Results overall cohort consisted 255, 39, 42 CABG, replacement/repair, + repair/replacement, respectively. Baseline characteristics similar among groups except younger age (p=0.0014), prevalence myocardial infarction (p=0.002) lower ejection fraction (p=0.025) in group. Eighteen hospitalization. more likely experience (Log-Rank ptrend=0.0096). Among monitoring, probability surgery, 15.8%, 29.4%, 35.0%, respectively ptrend=0.017). After multivariable adjustment, remained (hazard ratio (HR) 2.22, 95% CI 1.01–4.87. repair/replacement had highest experiencing when (HR 2.78, 1.12–6.86). Conclusion repair bioprosthetic replacement substantial surgery. An aggressive strategy vulnerable period should be considered high-risk patient population. Funding Acknowledgement Type funding sources: Other. Main source(s): Heart Stroke Foundation Canada