{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T22:55:28Z","timestamp":1785884128519,"version":"3.56.0"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Postoperative atrial fibrillation (POAF) is a frequent entity after cardiac surgery. However, its potential relationship with adverse outcomes and permanent arrhythmias remains uncertain. We sought to assess the relationship between the occurrence of atrial fibrillation (AF) in the postoperative period and its long-term recurrence.<\/jats:p>\n                  <jats:p>Patients who underwent aortic valve replacement (AVR) with a biological prosthesis between 2005 and 2023 were analyzed at our center. The incidence of atrial fibrillation in the postoperative period and the factors associated with its occurrence, as well as its long-term recurrence and related risk factors, were analyzed.<\/jats:p>\n                  <jats:p>The incidence of POAF was 22%. Postoperative renal insufficiency (p\u2009&lt;\u20090.001) and chronic obstructive pulmonary disease (COPD) (p\u2009=\u20090.047) were identified as risk factors. During long-term clinical follow-up (mean 6.5\u2009\u00b1\u20094.5 years), 20.4% of patients without any previous arrhythmia episodes developed AF, whereas the incidence was 40.4% in those with atrial fibrillation in the postoperative period (Hazard Ratio [HR]\u2009=\u20092.18 [1.33\u20133.56]; p\u2009=\u20090.002). AF during follow-up was independently associated with age (HR\u2009=\u20091.05), COPD (HR\u2009=\u20093.22), and POAF (HR\u2009=\u20091.9). In addition, there was an apparent association between permanent AF during follow-up and long-term mortality, which approached statistical significance (HR\u2009=\u20091.4 [95% CI: 0.9\u20131.8]; p\u2009=\u20090.06).<\/jats:p>\n                  <jats:p>POAF is a frequent complication following AVR and is significantly associated with an increased risk of developing permanent AF during long-term follow-up. Multivariate analysis identified renal insufficiency and COPD as independent predictors of POAF, while age and COPD were independently associated with long-term AF. Additionally, there was a trend toward an association between permanent AF and increased long-term mortality.<\/jats:p>","DOI":"10.1055\/a-2722-4150","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T23:14:47Z","timestamp":1760483687000},"page":"378-383","source":"Crossref","is-referenced-by-count":1,"title":["Postoperative Atrial Fibrillation after Aortic Valve Replacement: An Isolated Episode?"],"prefix":"10.1055","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4605-8801","authenticated-orcid":false,"given":"Laura","family":"Varela Barca","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Hospital Universitario de la Princesa, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nieves","family":"De Antonio Ant\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Hospital Universitario de la Princesa, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Auquilla Luzuriaga","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Hospital Universitario de la Princesa, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esperanza","family":"Gomez Alonso","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Hospital Universitario de la Princesa, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Roldan Martinez","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Universidad Aut\u00f3noma de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Mongui\u00f3 Sant\u00edn","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Hospital Universitario de la Princesa, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Alfonso Manterola","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de la Princesa, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Reyes Copa","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Hospital Universitario de la Princesa, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,10,28]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"329","DOI":"10.3949\/ccjm.89a.21003","article-title":"Anticoagulation management of post-cardiac surgery new-onset atrial fibrillation","volume":"89","author":"G Alhatemi","year":"2022","journal-title":"Cleve Clin J 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Anesth"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1093\/icvts\/ivz094","article-title":"Postoperative atrial fibrillation after aortic valve replacement is a risk factor for long-term atrial fibrillation","volume":"29","author":"R Carter-Storch","year":"2019","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"e153","DOI":"10.1016\/j.jtcvs.2014.06.036","article-title":"2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures","volume":"148","author":"G Frendl","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"14","key":"ref7","doi-asserted-by":"crossref","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":"U Benedetto","year":"2020","journal-title":"Circulation"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1093\/ejcts\/ezx039","article-title":"Postoperative atrial fibrillation following cardiac surgery: a persistent complication","volume":"52","author":"J W Greenberg","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"issue":"12","key":"ref9","doi-asserted-by":"crossref","first-page":"e0209687","DOI":"10.1371\/journal.pone.0209687","article-title":"Mortality and causes of death in patients with atrial fibrillation: a nationwide population-based study","volume":"13","author":"E Lee","year":"2018","journal-title":"PLoS One"},{"issue":"S 01","key":"ref10","doi-asserted-by":"crossref","first-page":"ehae666.457","DOI":"10.1093\/eurheartj\/ehae666.457","article-title":"Comorbidities and risk of death in atrial fibrillation: a nationwide cohort study","volume":"45","author":"A Aro","year":"2024","journal-title":"Eur Heart 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patients undergoing mitral valve surgery?","volume":"89","author":"J M Stulak","year":"2010","journal-title":"Ann Thorac Surg"},{"issue":"04","key":"ref23","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.hrthm.2015.01.014","article-title":"Postoperative atrial fibrillation is not pulmonary vein dependent: results from a randomized trial","volume":"12","author":"B Kiaii","year":"2015","journal-title":"Heart Rhythm"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1186\/s13019-021-01611-x","article-title":"Posterior pericardiotomy to prevent new-onset atrial fibrillation after coronary artery bypass grafting: a systematic review and meta-analysis of 10 randomized controlled trials","volume":"16","author":"T Xiong","year":"2021","journal-title":"J Cardiothorac Surg"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.jacc.2020.10.049","article-title":"Calcium-induced autonomic denervation in patients with post-operative atrial fibrillation","volume":"77","author":"H Wang","year":"2021","journal-title":"J Am Coll Cardiol"},{"issue":"03","key":"ref26","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s00210-023-02402-y","article-title":"Botulinum toxin for prevention of post-operative atrial fibrillation","volume":"396","author":"A Saljic","year":"2023","journal-title":"Naunyn Schmiedebergs Arch Pharmacol"},{"issue":"01","key":"ref27","first-page":"CD003611","article-title":"Interventions for preventing post-operative atrial fibrillation in patients undergoing heart surgery","volume":"2013","author":"K A Arsenault","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"issue":"11","key":"ref28","first-page":"e563","article-title":"2019 ACC\/AHA guideline on the primary prevention of cardiovascular disease: executive summary: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice 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