Clinical trial NCT06958029: Postoperative Atrial Fibrillation in Cardiac Surgery
Official title: Incidence and Risk Factors of Postoperative Atrial Fibrillation in Cardiac Surgery Patients
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Post-operative Atrial Fibrillation
Keywords: postoperative
atrial fibrillation
cardiac surgery
Lead sponsor: Khon Kaen University
Sponsor class: OTHER
First posted: 2025-05-06
Enrollment: 275
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Patients ubdergoing cardiac surgery

Brief summary: This multicenter observational study aims to investigate the incidence and identify risk factors associated with postoperative atrial fibrillation (POAF) in patients undergoing cardiac surgery at three medical centers in Thailand. The study will examine patient characteristics, surgical factors, and anesthetic management practices that may contribute to the development of this common postoperative complication.

Detailed description: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery, with incidence rates reported between 15-30% after valve surgery and 18-74% after coronary artery bypass grafting. POAF typically occurs within 72 hours after surgery and is associated with increased morbidity, mortality, length of hospital stay, and healthcare costs.

The Society of Thoracic Surgeons has identified five major postoperative complications associated with cardiac surgery, including POAF, which can significantly affect patient outcomes. This multicenter observational study will examine the incidence and risk factors of POAF in cardiac surgery patients across three medical centers in Thailand: Srinagarind Hospital at Khon Kaen University, Northeastern Thailand Cardiac Center, and Surat Thani Hospital.

The study will collect data on patient demographics, comorbidities, preoperative laboratory values, perioperative characteristics, surgical procedures (valve surgery, CABG, combined procedures), and postoperative complications. By identifying risk factors associated with POAF, this study aims to develop preventive strategies and improve management protocols for patients at high risk for this complication.

Eligibility criteria: Inclusion Criteria:

* Age ≥ 18 years
* Patients undergoing cardiac valve surgery or coronary artery bypass grafting (CABG) procedures

Exclusion Criteria:

* Patients undergoing aortic surgery
* Patients undergoing MAZE procedure
* Incomplete medical records
* Patients who required mechanical circulatory support before surgery
* Patients who died during surgery or within 3 days after surgery

Primary outcomes:
measure: Incidence
timeFrame: 72 hours postoperatively
Secondary outcomes:
measure: Risk factors
timeFrame: 72 hours postoperatively
Other outcomes:
Locations:
city: Khon Kaen
country: Thailand
facility: Faculty of Medicine, Khon Kaen University
Study officials:
affiliation: Khon Kaen University
name: Thepakorn Sathitkarnmanee, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Crawford TC, Magruder JT, Grimm JC, Suarez-Pierre A, Sciortino CM, Mandal K, Zehr KJ, Conte JV, Higgins RS, Cameron DE, Whitman GJ. Complications After Cardiac Operations: All Are Not Created Equal. Ann Thorac Surg. 2017 Jan;103(1):32-40. doi: 10.1016/j.athoracsur.2016.10.022. Epub 2016 Nov 22.
citation: Echahidi N, Pibarot P, O'Hara G, Mathieu P. Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery. J Am Coll Cardiol. 2008 Feb 26;51(8):793-801. doi: 10.1016/j.jacc.2007.10.043.
citation: Gudbjartsson T, Helgadottir S, Sigurdsson MI, Taha A, Jeppsson A, Christensen TD, Riber LPS. New-onset postoperative atrial fibrillation after heart surgery. Acta Anaesthesiol Scand. 2020 Feb;64(2):145-155. doi: 10.1111/aas.13507. Epub 2019 Dec 2.
citation: Melduni RM, Koshino Y, Shen WK. Management of arrhythmias in the perioperative setting. Clin Geriatr Med. 2012 Nov;28(4):729-43. doi: 10.1016/j.cger.2012.08.006.
citation: Lopes LA, Agrawal DK. Post-Operative Atrial Fibrillation: Current Treatments and Etiologies for a Persistent Surgical Complication. J Surg Res (Houst). 2022;5(1):159-172. doi: 10.26502/jsr.10020209. Epub 2022 Mar 28.