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Tafelmeier, Maria ; Kuettner, Sabrina ; Hauck, Christian ; Floerchinger, Bernhard ; Camboni, Daniele ; Creutzenberg, Marcus ; Zeman, Florian ; Schmid, Christof ; Maier, Lars Siegfried ; Wagner, Stefan ; Arzt, Michael

Sleep-Disordered Breathing, Advanced Age, and Diabetes Mellitus Are Associated with De Novo Atrial Fibrillation after Cardiac Surgery

Tafelmeier, Maria , Kuettner, Sabrina, Hauck, Christian , Floerchinger, Bernhard, Camboni, Daniele, Creutzenberg, Marcus, Zeman, Florian, Schmid, Christof, Maier, Lars Siegfried , Wagner, Stefan and Arzt, Michael (2024) Sleep-Disordered Breathing, Advanced Age, and Diabetes Mellitus Are Associated with De Novo Atrial Fibrillation after Cardiac Surgery. Biomedicines 12 (5), p. 1035.

Date of publication of this fulltext: 15 May 2024 13:07
Article
DOI to cite this document: 10.5283/epub.58277


Abstract

Background: Postoperative de novo atrial fibrillation (POAF) is one of the most frequently encountered complications following cardiac surgery. Despite the identification of several risk factors, the link between sleep-disordered breathing (SDB) and POAF has barely been examined. The objective of this prospective observational study was to determine whether severe SDB is associated with POAF in ...

Background: Postoperative de novo atrial fibrillation (POAF) is one of the most frequently encountered complications following cardiac surgery. Despite the identification of several risk factors, the link between sleep-disordered breathing (SDB) and POAF has barely been examined. The objective of this prospective observational study was to determine whether severe SDB is associated with POAF in patients after elective coronary artery bypass grafting (CABG) surgery. Study design and methods: The incidence and preoperative predictors of in-hospital POAF were assessed in 272 patients undergoing CABG surgery at the University Medical Center Regensburg (Germany). In-hospital POAF was detected by continuous telemetry-ECG monitoring and 12-lead resting ECGs within the first seven postoperative days. POAF that occurred after hospital discharge within 60 days post CABG surgery was classified as post-hospital POAF and was ascertained by standardized phone interviews together with the patients’ medical files, including routinely performed Holter-ECG monitoring at 60 days post CABG surgery. The night before surgery, portable SDB monitoring was used to assess the presence and type of severe SDB, defined by an apnea–hypopnea index ≥ 30/h. Results: The incidence of in-hospital POAF was significantly higher in patients with severe SDB compared to those without severe SDB (30% vs. 15%, p = 0.009). Patients with severe SDB suffered significantly more often from POAF at 60 days post CABG surgery compared to patients without severe SDB (14% vs. 5%, p = 0.042). Multivariable logistic regression analysis showed that severe SDB (odds ratio, OR [95% confidence interval, CI]: 2.23 [1.08; 4.61], p = 0.030), age ≥ 65 years (2.17 [1.04; 4.53], p = 0.038), and diabetes mellitus (2.27 [1.15; 4.48], p = 0.018) were significantly associated with in-hospital POAF. After additional adjustment for heart failure, the association between sleep apnea and postoperative atrial fibrillation was attenuated (1.99 [0.92; 4.31], p = 0.081). Conclusions: Amongst established risk factors, severe SDB was significantly associated with in-hospital POAF in patients undergoing CABG surgery. Whether SDB contributes to POAF independently of heart failure and whether risk for POAF may be alleviated by proper treatment of SDB merits further investigation.



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Details

Item typeArticle
Journal or Publication TitleBiomedicines
Publisher:MDPI
Volume:12
Number of Issue or Book Chapter:5
Page Range:p. 1035
Date8 May 2024
InstitutionsMedicine > Lehrstuhl für Innere Medizin II
Identification Number
ValueType
10.3390/biomedicines12051035DOI
Keywordscoronary artery bypass grafting (CABG); coronary artery disease; sleep apnea; postoperative complications
Dewey Decimal Classification600 Technology > 610 Medical sciences Medicine
StatusPublished
RefereedYes, this version has been refereed
Created at the University of RegensburgYes
URN of the UB Regensburgurn:nbn:de:bvb:355-epub-582775
Item ID58277

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