Abstract TP211: Outcomes and Predictors of Postoperative Atrial Fibrillation in Patients With Left Ventricular Assist Devices

Autor:	Andrew B. Civitello, O.H. Frazier, Mary Kim, Harveen K. Lamba, Todd K. Rosengart, S. Oberton, Brendan Chou, Ajith Nair, Ziad Taimeh, Reynolds M. Delgado, Jeffrey A. Morgan, Leo Simpson
Rok vydání:	2019
Předmět:	Advanced and Specialized Nursing medicine.medical_specialty business.industry Internal medicine medicine Cardiology Atrial fibrillation In patient Neurology (clinical) Cardiology and Cardiovascular Medicine medicine.disease business Cardiac surgery
Zdroj:	Stroke. 50
ISSN:	1524-4628 0039-2499
Popis:	Introduction: Postoperative atrial fibrillation (POAF) is one of the most common complications after cardiac surgery and is especially hazardous in elderly patients and those with left ventricular dysfunction. Therefore, we sought to find the associated risk factors and predictors for the development of POAF in patients undergoing left ventricular assist device (LVAD) implantation. Materials and methods: We retrospectively reviewed 109 patients with no prior history of atrial fibrillation undergoing continuous flow LVAD implantation at a single center institution from 2013-2017. Results: POAF lasting 24 hours or greater occurred in 29 of 109 patients (26.6%). Early 30-day mortality was higher in POAF patients compared to non-POAF (6.9% vs 0%, p=0.02) (Figure). Patients with POAF had higher rates of pump exchange although this did not reach statistical significance (17.2% vs 6.3%, p=0.08). However, POAF was not associated with stroke (10.3% vs 23.8%, p=0.24) or long-term mortality (27.6% vs 31.3%, p=0.8). The only independent risk factor for POAF was elevated pre-operative creatinine (OR: 2.5 95% CI: 1.3-4.6, p=0.004). Higher mean preoperative CHADS 2 (3.0 +/- 0.01 vs 2.4 +/- 0.5, p=0.01) and mean preoperative R 2 CHADS 2 (5.0 +/- 0.01 vs 4.4 +/- 0.5, p=0.01) scores were associated with POAF as compared to non-POAF. Conclusion: In patients undergoing continuous-flow left ventricular assist device implantation, postoperative atrial fibrillation was associated with higher rates of early mortality but not postoperative stroke or long-term mortality. Furthermore, higher preoperative CHADS 2 and R 2 CHADS 2 scores were associated with postoperative atrial fibrillation. However, the only independent predictor of post-operative atrial fibrillation in this small cohort was elevated preoperative creatinine.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::204aaf4842aafbea94a3abfa0e5dad3b https://doi.org/10.1161/str.50.suppl_1.tp211 Zobrazit plný text záznamu