PMID- 28496682
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1941-6911 (Print)
IS  - 1941-6911 (Electronic)
IS  - 1941-6911 (Linking)
VI  - 3
IP  - 4
DP  - 2010 Dec
TI  - Left Atrial Volume and Post-Operative Atrial Fibrillation after Aortic Valve 
      Replacement.
PG  - 338
LID - 10.4022/jafib.338 [doi]
LID - 338
AB  - Post-operative atrial fibrillation (POAF) after valve surgery is associated with 
      increased morbidity and mortality. Risk factors identified in the past to predict 
      POAF are of moderate accuracy. We performed a retrospective analysis of 139 
      patients undergoing aortic valve replacement for aortic stenosis. Post-operative 
      AF occurred in 44% of the patients. In multivariate analysis only left atrial 
      volume (LAV) index was a predictor of POAF. A LAV index of >46 cc/m2 predicted 
      POAF with a sensitivity and specificity of 92% and 77%. We propose that LAV index 
      can be used preoperatively to identify patients at risk for POAF to target 
      preventive interventions. Background: Post-operative atrial fibrillation (POAF) 
      is common after valve surgery and is associated with increased morbidity and 
      mortality. Many of the previously identified predictors of POAF are of moderate 
      accuracy. Left atrial volume (LAV) index has been proposed in the past as a 
      predictor of POAF in patients undergoing cardiac surgery. In patients with aortic 
      stenosis (AS), increased LAV is a marker of severity of stenosis. Hypothesis: 
      Left atrial volume index is a very good predictor of POAF in patients undergoing 
      aortic valve replacement (AVR) for AS. Methods: We performed a retrospective 
      analysis of 139 consecutive patients with no previous atrial fibrillation (AF) 
      undergoing AVR for AS in our center. Results: Post-operative AF occurred in 44% 
      of patients. Patients with POAF had a longer hospital stay compared to patients 
      without (12 vs 8 days; p < 0.001). In univariate analysis, age (p = 0.046), 
      aortic valve area (p = 0.005) and LAV index (p < 0.001) were significant 
      predictors of POAF. In multivariate analysis only LAV index (R2= 0.58; p < 0.001) 
      predicted POAF. A LAV index > 46ml/m2 predicted POAF with a sensitivity and 
      specificity of 92% and 77% respectively. Moreover, there was a significant 
      increase in the incidence of POAF with increasing quartiles of LAV index, 
      supporting causality. Conclusion: Left atrial volume index is an excellent 
      predictor of POAF in patients undergoing AVR for AS. It can be used for selecting 
      patients who are at a high risk for developing POAF to target preventive 
      interventions.
FAU - Madhu Reddy, Yeruva
AU  - Madhu Reddy Y
AD  - The Cardiac Center of Creighton University, Creighton University, Omaha, 
      Nebraska, USA.
FAU - Satpathy, Ruby
AU  - Satpathy R
AD  - The Cardiac Center of Creighton University, Creighton University, Omaha, 
      Nebraska, USA.
FAU - Shen, Xuedong
AU  - Shen X
AD  - The Cardiac Center of Creighton University, Creighton University, Omaha, 
      Nebraska, USA.
FAU - Holmberg, Mark
AU  - Holmberg M
AD  - The Cardiac Center of Creighton University, Creighton University, Omaha, 
      Nebraska, USA.
FAU - Hunter, Claire
AU  - Hunter C
AD  - The Cardiac Center of Creighton University, Creighton University, Omaha, 
      Nebraska, USA.
FAU - Mooss, Aryan
AU  - Mooss A
AD  - The Cardiac Center of Creighton University, Creighton University, Omaha, 
      Nebraska, USA.
FAU - Esterbrooks, Dennis
AU  - Esterbrooks D
AD  - The Cardiac Center of Creighton University, Creighton University, Omaha, 
      Nebraska, USA.
LA  - eng
PT  - Journal Article
DEP - 20101215
PL  - United States
TA  - J Atr Fibrillation
JT  - Journal of atrial fibrillation
JID - 101514767
PMC - PMC5398824
EDAT- 2010/12/15 00:00
MHDA- 2010/12/15 00:01
PMCR- 2010/12/15
CRDT- 2017/05/13 06:00
PHST- 2010/12/03 00:00 [received]
PHST- 2010/12/12 00:00 [revised]
PHST- 2010/12/12 00:00 [accepted]
PHST- 2017/05/13 06:00 [entrez]
PHST- 2010/12/15 00:00 [pubmed]
PHST- 2010/12/15 00:01 [medline]
PHST- 2010/12/15 00:00 [pmc-release]
AID - 10.4022/jafib.338 [doi]
PST - epublish
SO  - J Atr Fibrillation. 2010 Dec 15;3(4):338. doi: 10.4022/jafib.338. eCollection 
      2010 Dec.