Incidence and Prognostic Impact of Atrial Fibrillation After Discharge Following Revascularization for Significant Left Main Coronary Artery Narrowing

The incidence, recurrence rate and prognostic significance of atrial fibrillation or flutter (AF) following hospital discharge after percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) are unknown. We sought to determine the 3-year incidence and clinical impact of post-discharge AF in patients with LMCAD treated with PCI or CABG. In the EXCEL trial, 1905 patients with LMCAD were randomized to PCI versus CABG. We analyzed the occurrence of post-discharge AF through 3 years and its time-adjusted association with adverse outcomes. A total of 1802 patients without AF at baseline comprised the study cohort. Within 3 years, 227 episodes of AF occurred (29 [12.8%] in the PCI arm and 198 [87.2%] in the CABG arm, p