{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T09:58:03Z","timestamp":1790762283494,"version":"4.1.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Genomic and Precision Medicine"],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>New-onset postoperative atrial fibrillation (POAF) is a common surgical complication, yet the contribution of rare genetic variants to POAF is poorly characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We conducted a cohort study including 49\u2009913 adults who underwent surgery without a preoperative diagnosis of atrial fibrillation (AF). All participants had whole-genome sequencing linked to electronic health record data. Pathogenic or likely pathogenic (LP) variants were identified in 141 cardiac genes associated with early-onset AF. The primary outcome was POAF, defined as a new diagnosis of AF within 30 days of surgery; the secondary outcome was freedom from AF over 5 years. Multivariable regression and propensity-score matching were used to evaluate the associations between pathogenic\/LP variants and POAF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Among 49\u2009913 participants, 2298 underwent cardiac surgery and 47\u2009615 underwent noncardiac surgery. The prevalence of pathogenic\/LP variants was 6.0% in the cardiac surgery group (138\/2298) and 4.1% in the noncardiac surgery group (1947\/47\u2009615). Overall, carriers of \u22651 pathogenic\/LP variant had higher odds of POAF than noncarriers (6.6% versus 4.0%; odds ratio [OR], 1.8 [95% CI, 1.4\u20132.1]). In cardiac surgery, 36.0% of pathogenic\/LP carriers (78\/216) developed POAF versus 23.4% of noncarriers (492\/2082; OR, 2.3 [95% CI, 1.4\u20133.2]), and in noncardiac surgery, POAF occurred in 3.8% of carriers (74\/1947) versus 2.5% of noncarriers (1465\/45\u2009668; OR, 1.5 [95% CI, 1.2\u20131.9]). Pathogenic\/LP variants in cardiomyopathy-only genes (n=589; OR, 1.8 [95% CI, 1.3\u20132.6]) or in genes associated with both cardiomyopathy and arrhythmia (n=1059; OR, 1.8 [95% CI, 1.4\u20132.3]) were significantly associated with POAF, whereas variants in arrhythmia-only genes (n=454; OR, 1.3 [95% CI, 0.8\u20132.1]) were not. Five-year freedom from AF was lower among pathogenic\/LP variant carriers in both cardiac surgery (53% versus 64%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.010) and noncardiac surgery (92% versus 94%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Rare pathogenic\/LP variants in cardiomyopathy genes were associated with risk of POAF and reduced AF-free survival over long-term follow-up across cardiac and noncardiac surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circgen.125.005688","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T09:00:13Z","timestamp":1790758813000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Rare Cardiac Genetic Variation Is Associated With Postoperative Atrial Fibrillation"],"prefix":"10.1161","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5835-3840","authenticated-orcid":true,"given":"Zhanlin","family":"Chen","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Bluhm Cardiovascular Institute, Northwestern Medicine, Evanston, IL (Z.C., A.S.C., T.L., P.M.M., J.L.C., S.F.C., S.C.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anirudha S.","family":"Chandrabhatla","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Bluhm Cardiovascular Institute, Northwestern Medicine, Evanston, IL (Z.C., A.S.C., T.L., P.M.M., J.L.C., S.F.C., S.C.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7812-0860","authenticated-orcid":true,"given":"Anna","family":"Pfenniger","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (A.P., R.P., P.G.), Feinberg School of Medicine, Northwestern University, Evanston, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2351-236X","authenticated-orcid":true,"given":"Tom","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Bluhm Cardiovascular Institute, Northwestern Medicine, Evanston, IL (Z.C., A.S.C., T.L., P.M.M., J.L.C., S.F.C., S.C.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6729-2405","authenticated-orcid":true,"given":"Patrick M.","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Bluhm Cardiovascular Institute, Northwestern Medicine, Evanston, IL (Z.C., A.S.C., T.L., P.M.M., J.L.C., S.F.C., S.C.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4425-0824","authenticated-orcid":true,"given":"James L.","family":"Cox","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Bluhm Cardiovascular Institute, Northwestern Medicine, Evanston, IL (Z.C., A.S.C., T.L., P.M.M., J.L.C., S.F.C., S.C.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2759-9394","authenticated-orcid":true,"given":"Stephen F.","family":"Chiu","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Bluhm Cardiovascular Institute, Northwestern Medicine, Evanston, IL (Z.C., A.S.C., T.L., P.M.M., J.L.C., S.F.C., S.C.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8718-1534","authenticated-orcid":true,"given":"Rod","family":"Passman","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (A.P., R.P., P.G.), Feinberg School of Medicine, Northwestern University, Evanston, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6327-2439","authenticated-orcid":true,"given":"Philip","family":"Greenland","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine (A.P., R.P., P.G.), Feinberg School of Medicine, Northwestern University, Evanston, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2058-7289","authenticated-orcid":true,"given":"Adam","family":"Gordon","sequence":"additional","affiliation":[{"name":"Center of Genetic Medicine (A.G.), Feinberg School of Medicine, Northwestern University, Evanston, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0704-0334","authenticated-orcid":true,"given":"S. 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