Dangerous A-Fib Can Follow Many Surgeries

A potentially dangerous change in heart rhythm is common after surgeries that don’t involve the heart, according to Mayo Clinic researchers.

Dr. Konstantinos Siontis and colleagues studied patients who had atrial fibrillation (a-fib) after a noncardiac surgical procedure. These patients represent about 13% of a-fib diagnoses.

Postoperative a-fib is associated with a similar risk for stroke, transient ischemic attack (TIA, or mini stroke) and death as a-fib not related to surgery, the researchers said.

For the study, Siontis and his team compared the risk of TIA, ischemic stroke (one caused by blocked blood flow to the brain) and other outcomes in more than 4,200 patients with a-fib.

Of those, 550 patients, or 13%, had documented a-fib for the first time after surgery, most within a week. At one year, that percentage rose to 21%.

Compared to patients with a-fib not related to surgery, their risk of stroke, TIA or death was the same, the investigators found.

The researchers noted that a-fib after non-heart surgery may be triggered by stress and inflammation in patients with some pre-existing health conditions. Those who do develop a-fib within 30 days of surgery often have a recurrence later on, putting them at increased risk for blood clots (thromboembolism) and death compared with patients who had surgery but did not develop a-fib.

It remains unclear how postoperative a-fib compares with other cases of a-fib in terms of nonfatal and fatal outcomes.

Patients who have postoperative a-fib may need to be watched for abnormal heart rhythms (arrhythmias) and their complications, the study authors said in a news release from the American College of Physicians.

They also said some doctors may view postoperative a-fib as less serious than other cases and not prescribe anti-clotting medication as a result. This study shows that this view may be incorrect, the authors added.

The findings were published July 25 in the Annals of Internal Medicine.

More information

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

SOURCE: American College of Physicians, news release, July 25, 2022

Source: HealthDay