PMID- 12701782
OWN - NLM
STAT- MEDLINE
DCOM- 20030822
LR  - 20191210
IS  - 0966-8519 (Print)
IS  - 0966-8519 (Linking)
VI  - 12
IP  - 2
DP  - 2003 Mar
TI  - Prediction of paroxysmal atrial fibrillation after aortic valve replacement in 
      patients with aortic stenosis: identification of potential risk factors.
PG  - 136-41
AB  - BACKGROUND AND AIM OF THE STUDY: Paroxysmal atrial fibrillation (AF) is a 
      frequent complication after cardiac surgery. The study aim was to identify 
      preoperative predictors of risk for this condition in patients with aortic 
      stenosis after aortic valve replacement. METHODS: The influence of clinical, 
      echocardiographic and 24 h electrocardiogram (ECG) parameters on episodes of 
      paroxysmal AF after aortic valve replacement (AVR) in 423 patients (156 women, 
      267 men; mean age 58 +/- 10 years) with aortic stenosis was analyzed. Episodes of 
      postoperative paroxysmal AF were noted in 120 patients (28%). RESULTS: Univariate 
      analyses identified the following variables as risk factors for arrhythmia: age, 
      NYHA functional class, history of preoperative paroxysmal AF, left ventricular 
      mass index, >300 supraventricular beats on 24h ECG before surgery, presence of 
      supraventricular tachycardia (SVT), SVT of >5 beats or with a rate >120 
      beats/min. Concomitant coronary artery bypass (CABG) grafting and presence of 
      enlarged left atrium had no impact. By multivariate analysis, four variables were 
      identified as independent predictors: age (odds ratio 1.7; 95% CI 1.2-2.1); 
      history of paroxysmal AF (OR 3.2; CI 1.4-7.3); presence of >300 supraventricular 
      beats/24 h (OR 1.9; CI 1.1-3.4); and presence of SVT (OR 2.1; CI 1.3-3.4). 
      Discriminatory analysis revealed that a model comprising these four parameters 
      enabled risk prediction in 68% of patients. CONCLUSION: In patients with isolated 
      aortic stenosis, age, past history of paroxysmal AF episodes, >300 
      supraventricular beats/24 h and presence of SVT during 24 h before AVR were 
      predictors of postoperative paroxysmal AF episodes. Left atrial diameter and 
      simultaneous CABG during AVR did not influence the likelihood of postoperative 
      paroxysmal AF.
FAU - Orlowska-Baranowska, Ewa
AU  - Orlowska-Baranowska E
AD  - Institute of Cardiology, Warsaw, Poland.
FAU - Baranowski, Rafa
AU  - Baranowski R
FAU - Michalek, Piotr
AU  - Michalek P
FAU - Hoffman, Piotr
AU  - Hoffman P
FAU - Rywik, Tomasz
AU  - Rywik T
FAU - Rawczylska-Englert, Irena
AU  - Rawczylska-Englert I
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - J Heart Valve Dis
JT  - The Journal of heart valve disease
JID - 9312096
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/diagnostic imaging/pathology/surgery
MH  - Aortic Valve Stenosis/epidemiology/*surgery
MH  - Atrial Fibrillation/diagnosis/epidemiology/*etiology
MH  - Atrial Premature Complexes/diagnosis/epidemiology/etiology
MH  - Coronary Artery Bypass
MH  - Echocardiography
MH  - Electrocardiography, Ambulatory
MH  - Female
MH  - Heart Atria/diagnostic imaging/pathology
MH  - Heart Rate/physiology
MH  - *Heart Valve Prosthesis Implantation
MH  - Heart Ventricles/diagnostic imaging/physiopathology
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Postoperative Complications/diagnosis/epidemiology/*etiology
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Recurrence
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Stroke Volume/physiology
MH  - Treatment Outcome
EDAT- 2003/04/19 05:00
MHDA- 2003/08/23 05:00
CRDT- 2003/04/19 05:00
PHST- 2003/04/19 05:00 [pubmed]
PHST- 2003/08/23 05:00 [medline]
PHST- 2003/04/19 05:00 [entrez]
PST - ppublish
SO  - J Heart Valve Dis. 2003 Mar;12(2):136-41.