The following is the summary of “Atrial fibrillation after cardiac surgery: A systematic review and meta-analysis” published in the January 2023 issue of Thoracic and cardiovascular surgery by Caldonazo, et al.


Up to 60% of patients who undergo cardiac surgery develop postoperative atrial fibrillation (POAF) for the first time after the operation. Stroke, both in the immediate and far future, has been linked to POAF, although the condition’s connection with other cardiovascular events is less well understood. The goal of this review was to conduct a meta-analysis of studies that have reported a connection between POAF and perioperative and long-term outcomes in patients undergoing cardiac surgery.  Their team conducted a meta-analysis and systematic evaluation of articles reporting cardiac surgery outcomes according to the presence or absence of persistent obstructive airway dysfunction (POAF). 57 studies involving 246,340 patients were chosen after a search of MEDLINE, EMBASE, and the Cochrane Library. 

The primary endpoint was the rate of death during surgery. The inverse-variance technique and a random model were employed. Researchers used techniques like metaregression, subgroup analysis, and the “leave-one-out” method. POAF was associated with perioperative mortality (odds ratio [OR], 1.92; 95% CI, 1.58-2.33), perioperative stroke (OR, 2.17; 95% CI, 1.90-2.49), perioperative myocardial infarction (OR, 1.28; 95% CI, 1.06-1.54), perioperative acute renal failure (OR, 2.74; 95% CI, 2.42-3.11), hospital (standardized mean difference, 0.80; 95% CI, 0.53-1.07) and intensive care unit stay (standardized mean difference, 0.55; 95% CI, 0.24-0.86).

long-term mortality (incidence rate ratio [IRR], 1.54; 95% CI, 1.40-1.69), long-term stroke (IRR, 1.33; 95% CI, 1.21-1.46), and longstanding persistent atrial fibrillation (IRR, 4.73; 95% CI, 3.36-6.66). The findings indicate that POAF is linked to an increased risk of developing a wide variety of cardiovascular complications, both immediately and over time. The direction of causation, however, has yet to be determined.

Source: sciencedirect.com/science/article/abs/pii/S0022522321005584