17-02: Newly Developed Post-Operative Atrial Fibrillation is Associated with an Increased Risk of Late Recurrence of Atrial Fibrillation in patients who underwent Open Heart Surgery; Long-Term Follow up

Background: We sought to determine whether the occurrence of post-operative atrial fibrillation (POAF) increases the risk of late recurrence of AF in patients undergoing open heart surgery (OHS). Methods and Results: This study included 938 patients (56.7 ± 13.1 years old, 550 males) with no history of AF who underwent OHS. All patients were monitored continuously for development of POAF after surgery until the time of hospital discharge and received clinical follow up with serial evaluation of rhythm status. Among the total population, POAF occurred in 180 patients (19.2%) and late AF in 110 patients (11.7%) during the mean follow up period of 78.1 ± 39.1 months. Development of late AF occurred more frequently in patients with POAF than in those without [30.6 % (55/180) vs. 7.3% (55/758), p < 0.001]. Higher septal E/e' ratio (OR 1.041, 95% CI: 1.015–1.067, p = 0.002) reflecting high left ventricular end-diastolic pressure on the echocardiogram and an episode of POAF (OR 3.684, 95% CI: 2.092–6.488, p < 0.001) were independent predictors of late occurrence of AF. Conclusions: POAF is significantly associated with an increased risk of late AF recurrence during long-term follow up. Careful concern regarding late recurrence of AF with serial evaluation of rhythm status is required in patients with POAF.