DALLAS, Nov. 16, 2020 -- Atrial fibrillation (AF), an irregular heartbeat that can increase the likelihood of stroke, was detected up to 10 times more frequently in high risk patients recovering from heart surgery who wore a continuous cardiac monitor for a month, compared to patients who had usual follow-up care following their procedure, according to late breaking research presented today at the American Heart Association's Scientific Sessions 2020. The meeting is virtually, Friday, November 13-Tuesday, November 17, 2020, and is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science for health care worldwide.
"The incidence of post-operative atrial fibrillation (POAF) after discharge from cardiac surgery is not well defined," said Subodh Verma, M.D., Ph.D., a cardiac surgeon at St. Michael's Hospital, University of Toronto in Canada, and one of the lead authors of the study. "Most studies are limited to the hospitalization phase only; studies beyond hospitalization are few. In addition, very little is known about patients who have little to no AF during hospitalization after cardiac surgery, and they are often sent home with no treatment. Therefore, the question of whether the risk of POAF extends after hospitalization remains an important and unanswered question, especially for patients who had no previous history of AF. Quantifying the risk of ongoing POAF after hospitalization is important because many patients have elevated stroke risk scores that increase the need for prompt AF treatment."
Researchers followed a total of 336 patients treated at eight medical centers across Canada who were recovering from cardiac surgery. The study participants did not have a history of atrial fibrillation prior to surgery and were at-risk for stroke based upon factors including their cardiac health, age and medical history.
The patients in the study were randomly assigned to two groups: 163 study participants underwent 30 days of 24-hour, real time, cardiac rhythm monitoring through an adhesive, patch-based monitor worn on their chest; 173 participants were in the control group and received 30 days of usual care, which did not involve planned cardiac rhythm testing/electrocardiogram assessment unless it was deemed medically necessary. The patients in both groups then had 14 days of continuous cardiac rhythm monitoring approximately six to nine months after their surgery.
The study determined that in the patient group who wore the 24-hour monitoring patch, atrial fibrillation was detected at a rate 10 times higher than in those who received usual care. Atrial fibrillation or atrial flutter lasting ?6 minutes occurred and was detected in 32 (19.6%) patients from the monitoring group and in three (1.7%) patients who received normal care during the 30 days they were followed.
"Our study points to the fact that POAF is not self-limited to hospital stay per se. A significant risk of POAF persists even in those patients without any preoperative or pre-discharge AF. These data may help inform physicians about the importance of surveillance and vigilance in patients at high risk of stroke with respect to monitoring and prompt treatment for AF," added Verma.
###
Co-authors of the study include Andrew Ha, M.D.; David Mazer, M.D.; Adrian Quan, M. Phil.; David Latter, M.D.; Bobby Yanagawa, M.D.; Marnee Wilson, N.P.; Terrence Yau, M.D.; Frederic Jacques, M.D.; Craig Brown, M.D.; Rohit Singal, M.D., M.Sc.; Michael Yamashita, M.D.; Tarit Saha, M.D.; Kevin Teoh, M.D.; Buu-khanh Lam, M.D., M.P.H.; Andrew Kosmopoulos, B.H.Sc.; Marc Deyell, M.D., M.Sc.; Chris Cheung, M.D.; Vinay Garg, M.D., M.Sc.; Shira Brodutch, M.Sc.; Hwee Teoh, M.D.; Fei Zuo, M.S., M.P.H.; Kevin Thorpe, M.Math; Peter Juni, M.D.; Deepak L. Bhatt, M.D., M.P.H.; and Atul Verma, M.D. Author disclosures are detailed in the abstract.
The study was funded by the Heart and Stroke Foundation of Canada with unrestricted grants from Bristol Myers Squibb, Pfizer and Boehringer Ingelheim.
Note: Session: To Screen or Not to Screen, and then What? Studies of Detection and Treatment of AF
Additional Resources:
Multimedia is available on the right column of the release link https://newsroom.heart.org/news/patients-at-risk-of-atrial-fibrillation-may-need-additional-monitoring-after-heart-surgery?preview=0d8193a48893351f123b0e327382e940
What is Atrial Fibrillation (AFib or AF)
Joining Forces for Atrial Fibrillation Patients
For more news at AHA Scientific Sessions 2020, follow us on Twitter @HeartNews
Statements and conclusions of studies that are presented at the American Heart Association's scientific meetings are solely those of the study authors and do not necessarily reflect the Association's policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers are available here, and the Association's overall financial information is available here.
About the American Heart Association
The American Heart Association is a leading force for a world of longer, healthier lives. With nearly a century of lifesaving work, the Dallas-based association is dedicated to ensuring equitable health for all. We are a trustworthy source empowering people to improve their heart health, brain health and well-being. We collaborate with numerous organizations and millions of volunteers to fund innovative research, advocate for stronger public health policies, and share lifesaving resources and information. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.