Postoperative atrial fibrillation after aortic valve replacement in patients with aortic valve regurgitation

The aim – to determine the frequency of postoperative atrial fibrillation (POAF) and risk factors for its development in patients with aortic regurgitation who underwent aortic valve replacement.Materials and methods. The study included 86 patients with aortic regurgitation who underwent aortic valve replacement. Patients were divided into 2 groups: Group I – 32 people who developed POAF, Group II – 54 patients without arrhythmia. Demographic, preoperative general clinical, instrumental, and electrophysiological indicators, as well as intraoperative and early postoperative parameters in these groups of patients were compared. Results. Patients in Group І had significantly more hypertension, chronic kidney disease, smoking, and use of median sternotomy. By means of ROC analysis, such predictors of POAF were determined: left atrial diameter, left atrial volume, left atrial volume index (LAVI), LV end-diastolic diameter (LV EDD), LV end-diastolic volume (LV EDV), end-diastolic volume index (EDVI), thyroid-stimulating hormone (TSH) and glomerular filtration rate (GFR), duration of cardiopulmonary bypass, aortic cross-clamp time duration and median sternotomy.Conclusions. The incidence of POAF in patients with aortic valve regurgitation who underwent aortic valve replacement was 37.2 %. Significant risk factors for POAF in these patients were: hypertension, smoking, left atrial diameter > 45.5 mm, its volume > 92.5 cm3, LAVI > 44.4 mL/m2, LV EDD > 63.5 mm, LV EDV > 214.5 mL, EDVI > 106.2 mL/m2, TSH > 4.75 mU/L and GFR < 99.8 mL/min, duration of cardiopulmonary bypass > 69.5 min, aortic cross-clamp time duration > 50.5 min, duration of operation > 155 min, use of median sternotomy.