PLoS ONE (Jan 2019)

Incidence and complications of perioperative atrial fibrillation after non-cardiac surgery for malignancy.

  • Satoshi Higuchi,
  • Yusuke Kabeya,
  • Kenichi Matsushita,
  • Nobuaki Arai,
  • Keisei Tachibana,
  • Ryota Tanaka,
  • Riken Kawachi,
  • Hidefumi Takei,
  • Yutaka Suzuki,
  • Masaharu Kogure,
  • Yorihisa Imanishi,
  • Kiyoshi Moriyama,
  • Tomoko Yorozu,
  • Koichiro Saito,
  • Nobutsugu Abe,
  • Masanori Sugiyama,
  • Haruhiko Kondo,
  • Hideaki Yoshino

DOI
https://doi.org/10.1371/journal.pone.0216239
Journal volume & issue
Vol. 14, no. 5
p. e0216239

Abstract

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BackgroundPerioperative atrial fibrillation (POAF) is one of the common arrhythmias in the setting of non-cardiac surgeries for malignancy. As POAF may cause subsequent adverse events, it is important to confirm its characteristics and risk factors.Materials and methodsThe prospective cohort study of surveillance for perioperative atrial fibrillation recurrence (PREDICT AF RECURRENCE) is an ongoing prospective, single-center, observational study that aims to illustrate the clinical impact of POAF in major non-cardiac surgery for malignancy. Patients who planned to undergo non-cardiac surgery for definitive/suspected malignancy were registered. Those with a history of AF and atrial flutter were excluded. Any 30-day complications included acute myocardial infarction, congestive heart failure, bleeding, thrombosis, any infection, and acute kidney injury. The primary endpoint was an incidence of POAF.ResultsThe present study included 799 patients (age, 68 ± 11; male, 62%). Of these, 80 patients (10.0%) developed POAF. Notably, 66 patients (83%) had no symptoms. Any 30-day complications occurred in 180 patients (23%) (with POAF: 34 (43%); without POAF: 146 (20%); p ConclusionTen percent of patients who underwent non-cardiac surgery for malignancy developed POAF, which was strongly associated with perioperative complications. As a majority were asymptomatic, careful observation using electrocardiography monitoring is important to avoid oversights.Clinical trial registrationUMIN ID: UMIN000016146.