{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T12:56:20Z","timestamp":1793278580636,"version":"4.5.0"},"reference-count":32,"publisher":"American Medical Association (AMA)","issue":"20","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2025,11,25]]},"abstract":"\n Importance<\/jats:title>\n The incidence and burden of new-onset atrial fibrillation (AF) after coronary artery bypass grafting (CABG) are not known. Nevertheless, North American guidelines state that it is reasonable to administer 60 days of oral anticoagulation to patients with new-onset AF after CABG, a moderate-strength recommendation (class 2a) based on evidence derived from nonrandomized clinical studies.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To test the hypothesis that the incidence of new-onset AF within the first year after CABG is higher than suggested in the current literature and to assess AF burden.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n A prospective, multicenter cohort study in 2 academic cardiac surgery centers in Germany that involved 198 patients with 3-vessel coronary artery disease or left main disease and no history of arrhythmias who received an insertable cardiac monitor during CABG for long-term continuous electrocardiographic monitoring. Patients were enrolled from November 2019 through November 2023 and were followed up for 1 year.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Atrial fibrillation detected within a year of continuous monitoring using insertable cardiac monitors implanted during CABG.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Cumulative incidence of new-onset AF within a year of surgery. Secondary outcomes were AF burden and clinical outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 1217 patients were assessed, and 1008 were excluded. Of the 198 patients enrolled (173 male [87.4%]; 25 female [12.6%]; mean age, 66 [SD, 9] years), 95 patients developed new-onset AF within the first year after CABG (cumulative incidence, 48%; 95% CI, 41%-55%). The median AF burden during the first year was 0.07% (IQR, 0.02%-0.23%) or 370 minutes. The median AF burden on days 1 through 7 was 3.65% (IQR, 0.95%-9.09%); on days 8 through 30, 0.04% (IQR, 0%-1.21%); and on days 31 through 365, 0% (IQR, 0%-0.0003%), corresponding to 368, 13, and 0 minutes, respectively. After discharge, 3 patients had an AF episode longer than 24 hours.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n Although the incidence of new-onset AF after CABG in this study was higher than previously reported, the AF burden in these patients was very low, especially after 30 days. The very low AF burden questions the current guideline recommendations that long-term oral anticoagulation should be considered in patients with new-onset AF after CABG.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2025.14891","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T14:30:18Z","timestamp":1760020218000},"page":"1827","source":"Crossref","is-referenced-by-count":31,"title":["Long-Term Continuous Monitoring of New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting"],"prefix":"10.1001","volume":"334","author":[{"given":"Florian E. M.","family":"Herrmann","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, LMU University Hospital, LMU Munich, Munich, Germany"},{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"DZHK (German Center for Cardiovascular Research) partner site Munich Heart Alliance, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Jeppsson","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hristo","family":"Kirov","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstratios I.","family":"Charitos","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Dacian","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, LMU University Hospital, LMU Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Br\u00f6msen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Stiftsklinik Augustinum, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Massberg","sequence":"additional","affiliation":[{"name":"DZHK (German Center for Cardiovascular Research) partner site Munich Heart Alliance, Munich, Germany"},{"name":"Department of Medicine, LMU University Hospital, LMU Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Sadoni","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, LMU University Hospital, LMU Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Doenst","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Juchem","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, LMU University Hospital, LMU Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Hagl","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, LMU University Hospital, LMU Munich, Munich, Germany"},{"name":"DZHK (German Center for Cardiovascular Research) partner site Munich Heart Alliance, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"19","key":"joi250064r1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.030907","article-title":"Differences in postoperative atrial fibrillation incidence and outcomes after cardiac surgery according to assessment method and definition: a systematic review and meta-analysis.","volume":"12","author":"Perezgrovas-Olaria","year":"2023","journal-title":"J Am Heart Assoc"},{"issue":"1","key":"joi250064r2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.017966","article-title":"New-onset atrial fibrillation after coronary artery bypass grafting and long-term outcome: a population-based nationwide study from the SWEDEHEART registry.","volume":"10","author":"Taha","year":"2021","journal-title":"J Am Heart Assoc"},{"issue":"14","key":"joi250064r3","doi-asserted-by":"publisher","first-page":"1320","DOI":"10.1161\/CIRCULATIONAHA.120.046940","article-title":"Postoperative atrial fibrillation and long-term risk of stroke after isolated coronary artery bypass graft surgery.","volume":"142","author":"Benedetto","year":"2020","journal-title":"Circulation"},{"issue":"1","key":"joi250064r4","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1161\/CIR.0000000000001193","article-title":"2023 ACC\/AHA\/act\/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines.","volume":"149","author":"Joglar","year":"2024","journal-title":"Circulation"},{"issue":"36","key":"joi250064r5","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS).","volume":"45","author":"Van Gelder","year":"2024","journal-title":"Eur Heart J"},{"issue":"10316","key":"joi250064r6","doi-asserted-by":"publisher","first-page":"2075","DOI":"10.1016\/S0140-6736(21)02490-9","article-title":"Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery: an adaptive, single-center, single-blind, randomised, controlled trial.","volume":"398","author":"Gaudino","year":"2021","journal-title":"Lancet"},{"issue":"20","key":"joi250064r7","doi-asserted-by":"publisher","first-page":"1911","DOI":"10.1056\/NEJMoa1602002","article-title":"Rate control versus rhythm control for atrial fibrillation after cardiac surgery.","volume":"374","author":"Gillinov","year":"2016","journal-title":"N Engl J Med"},{"issue":"7","key":"joi250064r8","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1016\/j.jacc.2017.12.012","article-title":"New-onset atrial fibrillation after PCI or CABG for left main disease: the excel trial.","volume":"71","author":"Kosmidou","year":"2018","journal-title":"J Am Coll Cardio"},{"key":"joi250064r9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2024.131930","article-title":"Recurrence of new-onset post-operative AF after cardiac surgery: detected by implantable loop recorders: a systematic review and meta-analysis.","volume":"404","author":"Kaur","year":"2024","journal-title":"Int J Cardiol"},{"issue":"12","key":"joi250064r10","doi-asserted-by":"publisher","first-page":"1922","DOI":"10.1093\/europace\/euab136","article-title":"Clinical and electrophysiological predictors of device-detected new-onset atrial fibrillation during 3 years after cardiac surgery.","volume":"23","author":"Bidar","year":"2021","journal-title":"Europace"},{"issue":"9","key":"joi250064r11","doi-asserted-by":"publisher","first-page":"1134","DOI":"10.1016\/j.jacep.2021.02.005","article-title":"The incidence and natural progression of new-onset postoperative atrial fibrillation.","volume":"7","author":"Abdelmoneim","year":"2021","journal-title":"JACC Clin Electrophysiol"},{"issue":"10","key":"joi250064r12","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1111\/pace.12949","article-title":"Management of new-onset postoperative atrial fibrillation utilizing insertable cardiac monitor technology to observe recurrence of af (monitor-af).","volume":"39","author":"El-Chami","year":"2016","journal-title":"Pacing Clin Electrophysiol"},{"key":"joi250064r13","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1153275","article-title":"Subclinical postoperative atrial fibrillation: a randomized trial.","volume":"10","author":"Sabbag","year":"2023","journal-title":"Front Cardiovasc Med"},{"issue":"5","key":"joi250064r14","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1016\/j.jacep.2024.01.013","article-title":"Clinical predictors of device-detected atrial fibrillation during 2.5 years after cardiac surgery: prospective RACE V cohort.","volume":"10","author":"Gilbers","year":"2024","journal-title":"JACC Clin Electrophysiol"},{"issue":"3","key":"joi250064r15","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/j.hroo.2021.05.001","article-title":"The contribution of intermittent handheld electrocardiogram and continuous electrocardiogram monitoring with an implantable loop recorder to detect incident and recurrent atrial fibrillation during 1 year after coronary artery bypass graft surgery: a prospective cohort study.","volume":"2","author":"Sandgren","year":"2021","journal-title":"Heart Rhythm O2"},{"key":"joi250064r16","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.amjcard.2024.10.017","article-title":"Characterization of post coronary artery bypass grafting atrial fibrillation patterns: rationale and design of an investigator-initiated observational study.","volume":"234","author":"Herrmann","year":"2025","journal-title":"Am J Cardiol"},{"issue":"3","key":"joi250064r17","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euaf019","article-title":"Atrial fibrillation burden in clinical practice, research, and technology development: a clinical consensus statement of the European Society of Cardiology Council on Stroke and the European Heart Rhythm Association.","volume":"27","author":"Doehner","year":"2025","journal-title":"Europace"},{"issue":"20","key":"joi250064r18","doi-asserted-by":"publisher","first-page":"e623","DOI":"10.1161\/CIR.0000000000000568","article-title":"Atrial fibrillation burden: moving beyond atrial fibrillation as a binary entity: a scientific statement from the American Heart Association.","volume":"137","author":"Chen","year":"2018","journal-title":"Circulation"},{"issue":"5","key":"joi250064r19","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1001\/jamacardio.2018.0405","article-title":"Long-term thromboembolic risk in patients with postoperative atrial fibrillation after coronary artery bypass graft surgery and patients with nonvalvular atrial fibrillation.","volume":"3","author":"Butt","year":"2018","journal-title":"JAMA Cardiol"},{"issue":"12","key":"joi250064r20","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1001\/jama.2024.17888","article-title":"Potassium supplementation and prevention of atrial fibrillation after cardiac surgery: the TIGHT K randomized clinical trial.","volume":"332","author":"O\u2019Brien","year":"2024","journal-title":"JAMA"},{"issue":"10","key":"joi250064r21","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.7326\/M23-1411","article-title":"Atrial fibrillation recurrence in patients with transient new-onset atrial fibrillation detected during hospitalization for noncardiac surgery or medical illness: a matched cohort study.","volume":"176","author":"McIntyre","year":"2023","journal-title":"Ann Intern Med"},{"issue":"1","key":"joi250064r22","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.cjco.2021.09.011","article-title":"Short-term and long-term risk of stroke in patients with perioperative atrial fibrillation after cardiac surgery: systematic review and meta-analysis.","volume":"4","author":"Wang","year":"2021","journal-title":"CJC Open"},{"issue":"24","key":"joi250064r23","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.027010","article-title":"Risk and subtypes of stroke following new-onset postoperative atrial fibrillation in coronary bypass surgery: a population-based cohort study.","volume":"11","author":"Feilberg Rasmussen","year":"2022","journal-title":"J Am Heart Assoc"},{"issue":"12","key":"joi250064r24","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.020426","article-title":"New-onset perioperative atrial fibrillation after coronary artery bypass grafting and long-term risk of adverse events: an analysis from the coronary trial.","volume":"10","author":"Conen","year":"2021","journal-title":"J Am Heart Assoc"},{"issue":"2","key":"joi250064r25","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1016\/j.jtcvs.2020.01.077","article-title":"Anticoagulation and amiodarone for new atrial fibrillation after coronary artery bypass grafting: prescription patterns and 30-day outcomes in the United States and Canada.","volume":"162","author":"Matos","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"4","key":"joi250064r26","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1016\/j.hroo.2022.06.003","article-title":"Anticoagulation in new-onset postoperative atrial fibrillation: an analysis from the Society of Thoracic Surgeons Adult Cardiac Surgery Database.","volume":"3","author":"Riad","year":"2022","journal-title":"Heart Rhythm O2"},{"issue":"29","key":"joi250064r27","doi-asserted-by":"publisher","first-page":"2620","DOI":"10.1093\/eurheartj\/ehae267","article-title":"Anticoagulation for post-operative atrial fibrillation after isolated coronary artery bypass grafting: a meta-analysis.","volume":"45","author":"van de Kar","year":"2024","journal-title":"Eur Heart J"},{"key":"joi250064r28","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.amjcard.2025.03.036","article-title":"Anticoagulation vs no anticoagulation for postoperative atrial fibrillation after isolated coronary artery bypass graft: a meta-analysis.","volume":"249","author":"Shariff","year":"2025","journal-title":"Am J Cardiol"},{"issue":"13","key":"joi250064r29","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1056\/NEJMoa2303062","article-title":"Anticoagulation with edoxaban in patients with atrial high-rate episodes.","volume":"389","author":"Kirchhof","year":"2023","journal-title":"N Engl J Med"},{"issue":"13","key":"joi250064r30","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1161\/CIRCULATIONAHA.123.067512","article-title":"Direct oral anticoagulants for stroke prevention in patients with device-detected atrial fibrillation: a study-level meta-analysis of the NOAH-AFNET 6 and ARTESIA trials.","volume":"149","author":"McIntyre","year":"2024","journal-title":"Circulation"},{"issue":"2","key":"joi250064r31","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1056\/NEJMoa2310234","article-title":"Apixaban for stroke prevention in subclinical atrial fibrillation.","volume":"390","author":"Healey","year":"2024","journal-title":"N Engl J Med"},{"issue":"17","key":"joi250064r32","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.1093\/eurheartj\/ehx042","article-title":"Duration of device-detected subclinical atrial fibrillation and occurrence of stroke in ASSERT.","volume":"38","author":"Van Gelder","year":"2017","journal-title":"Eur Heart J"}],"container-title":["JAMA"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/articlepdf\/2839710\/jama_herrmann_2025_oi_250064_1763752239.66152.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T16:00:45Z","timestamp":1764086445000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2839710"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,25]]},"references-count":32,"journal-issue":{"issue":"20","published-print":{"date-parts":[[2025,11,25]]}},"URL":"https:\/\/doi.org\/10.1001\/jama.2025.14891","relation":{},"ISSN":["0098-7484"],"issn-type":[{"value":"0098-7484","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11,25]]}}}