Heart failure

A-Fib after any surgery increases risk of heart failure – Consumer Health News

WEDNESDAY, July 6, 2022 (HealthDay News) — The risk of being hospitalized for heart failure after surgery is higher in patients who develop an abnormal heart rhythm, according to a large new study.

Of more than 76,000 cardiac surgery patients, approximately 18.8% developed postoperative atrial fibrillation (A-Fib). The researchers found that their risk of hospitalization increased by a third compared to patients who did not develop A-Fib.

And, of the nearly 3 million patients with no history of heart disease who underwent surgery for other conditions, 0.8% also developed fibrosis A, doubling their risk of hospitalization for heart failure.

“This could mean that atrial fibrillation is an important indicator of underlying but as yet undetected heart failure; or it could mean that atrial fibrillation itself contributes to the future development of heart failure,” said the study’s first author, Dr. Parag Goyal, associate professor at Weill Cornell Medicine in New York.

While this study can’t determine which of these mechanisms is at play, Goyal said he hopes it will lead to further investigation.

Although doctors viewed postoperative A-Fib as a mild consequence of surgery-related stress, the study noted that new evidence suggests it may be linked to longer-term problems, including stroke. stroke and premature death from any cause.

For this study, researchers used health claims data from acute care hospitals in 11 states between 2016 and 2018. Patients were ages 18 and older and were followed for an average of 1.7 years. The researchers adjusted for age, gender, race, insurance status, medical history, and body mass index (an estimate of body fat based on height and weight).

An observational study, the results cannot prove that postoperative atrial fibrillation causes heart failure, only that there is an association. But Goyal said his height is a strength.

“Most importantly, patients and physicians need to be more alert to symptoms of heart failure in patients who develop postoperative atrial fibrillation,” he said. “Those who develop the disease may need more aggressive treatments for other risk factors for heart failure, such as high blood pressure, diabetes and narrowing of the arteries.

Researchers hope to investigate the matter further, to understand why this might be happening and how it might be prevented.

The results were published on June 28 in the European journal of the heart.

A team from the Smidt Heart Institute at Cedars-Sinai in Los Angeles – Dr. Christine Albert and Melissa Middledorp – wrote a commentary that accompanied the study.

They noted that the findings add to a growing body of evidence suggesting that Postoperative A-Fib may be more than an answer to surgery. Rather, it may reflect underlying structural changes that may also predispose a patient to other potentially related adverse cardiac events, such as heart failurethey wrote.

“With a better understanding of the full risk factor profile of patients, we can advocate for early aggressive intervention at the initial manifestation of [post-operative A-Fib]to improve outcomes and reduce rehospitalizations after cardiac and non-cardiac surgery,” they said.

More information

The US Centers for Disease Control and Prevention has more on atrial fibrillation.

SOURCE: European Society of Cardiology, press release, June 28, 2022

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