@Article{chd.12857,
AUTHOR = {Michael A. Brock, John‐Anthony Coppola, Jana Reid, Diego Moguillansky},
TITLE = {Atrial fibrillation in adults with congenital heart disease following cardiac surgery in a single center: Analysis of incidence and risk factors},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {6},
PAGES = {924--930},
URL = {http://www.techscience.com/schd/v14n6/38926},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> The primary aim of our work is to determine the incidence of atrial fibrillation following cardiac surgery in adults with congenital heart disease. Secondary 
aims include identifying risk factors predictive of developing early postoperative 
atrial fibrillation and morbidities associated with early postoperative atrial fibrillation.<br/>
<b>Design:</b> Retrospective analysis.<br/>
<b>Setting:</b> Single center, quaternary care children’s hospital.<br/>
<b>Patients:</b> This review included patients at least 18 years of age with known congenital heart disease who underwent cardiac surgery requiring a median sternotomy at 
our congenital heart center from January 1, 2012 to December 31, 2016.<br/>
<b>Interventions:</b> None.<br/>
<b>Outcome Measures:</b> The primary outcome was early postoperative atrial fibrillation. 
Secondary outcomes included preoperative comorbidities, preoperative echocardiographic findings, operative details, and postoperative morbidities, such length of 
stay, reintubation, stroke, and death.<br/>
<b>Results:</b> The incidence of early postoperative atrial fibrillation was 21%. Those who 
developed early postoperative atrial fibrillation were older (50 years vs 38 years, 
P =< .001), had a history of atrial fibrillation prior to surgery, had preoperative pulmonary hypertension, and had longer cardiopulmonary bypass times (103 minutes vs 
84 minutes, P = .025) when compared to those who did not develop postoperative 
atrial fibrillation. Multivariate analysis identified age greater than 60, preoperative 
pulmonary hypertension, mitral valve intervention, and the need for postoperative 
inotropic support as being independent predictors of postoperative atrial fibrillation. 
Those who developed postoperative atrial fibrillation remained in the hospital longer 
(9 days vs 7 days, P =< .001).<br/>
<b>Conclusions:</b> Atrial fibrillation is a common complication following cardiac surgery in 
adults with congenital heart disease. Age, preoperative comorbidities, type of surgical intervention, and the need for perioperative inotropic infusions may predict the 
risk of atrial fibrillation in this unique patient population.},
DOI = {10.1111/chd.12857}
}