Late incidence and recurrence of new-onset atrial fibrillation after isolated surgical aortic valve replacement

ABSTRACT Objectives Atrial fibrillation (AF) is a common complication after cardiac surgery. More knowledge is needed about the long-term AF recurrence and adverse outcomes related to new-onset atrial fibrillation (NOAF) during the index hospitalization. Methods A total of 1073 patients underwent isolated SAVR at the four participating hospitals (2002–2014). After the exclusion of patients with a history of any preoperative AF, the final study population included 529 patients in the bioprosthetic and 253 patients in the mechanical valve prosthesis cohort. Median follow-up time was 5.4 (interquartile range 3.4–8.2) years in the combined cohort Results Altogether 333 (42.6%) patients had in-hospital NOAF and 250 (32.0%) AF after hospital discharge. In the mechanical cohort, 64 (25.3%) experienced in-hospital NOAF and 74 (29.2%) AF after hospital discharge, whereas in the bioprosthetic cohort, 269 (50.9%) patients had in-hospital NOAF and 176 (33.3%) AF after hospital discharge. Patients with NOAF during the index hospital stay had a multifold risk of AF after hospital discharge in the combined cohort (HR 3.68, 95% CI 2.82-4.81, p Conclusions NOAF during the index hospitalization is associated with a 2–4-fold risk of later AF and 1.6–2.0-fold risk of all-cause mortality after both mechanical and bioprosthetic SAVR.