Postoperative Atrial Fibrillation Decreased Long-term Survival Rate in Isolated Valve Surgery

Background: Postoperative Atrial Fibrillation (POAF) is the most common complication of open cardiac surgery related to prognosis and morbidity. However, it is controversial whether POAF is associated with excess mortality independent of associated risk factors after cardiac surgery. Methods and results: POAF was identified in 425 patients (34.5%) of 1229 patients underwent isolated valve repair and/or replacement operation. Patients have more chances to experience POAF if they were older than 65 years old (p<0.0001), Caucasian (p=0.0017), with heart failure (NYHA Class >= III) (p<0.001), with hypertension (p<0.001) or with peripheral vascular diseases (p<0.001). The unadjusted fiveyear survival rate was 82.8% for patients without POAF and 71.3% for with POAF (p<0.0001). An unadjusted hazard ratio for POAF was 1.85 (95% CI: 1.40 to 2.43). With a propensity score-matching model, in the 406 pairs of patients under adjusted survival analysis showed significant lower survival rate in POAF (p=0.001) with the adjusted hazard ratio of 1.40 (95% CI: 1.01 to 1.92), compared to without POAF. Conclusion: Our present study supported that POAF is independently associated with an increased long-term mortality in patients who had isolated valve surgery.