Assessment of the frequency and possible risk factors for paroxysmal atrial fibrillation in the early postoperative period after transapical implantation of the MedLab-CT valve

Aim.  To study the incidence and possible risk factors for atrial fibrillation (AF) in the early postoperative period after transapical implantation of the first Russian aortic valve (TAP-AVI). Methods.  The study included 118 patients after successful TAP-AVI. Patients with open aortic valve replacement due to dislocation of the prosthesis were excluded, as well as subjects with permanent AF and who died in the early postoperative period. The mean age of the patients was 71.1±4.9 years, body mass index 31.1±5.9 kg/m2 , males - 39.8%, hypertension was present in 93.2%, diabetes mellitus (DM) - in 27.9%, paroxysmal AF - in 12.7%, coronary artery disease (CAD) was in 56.7%, 8.4% were smokers. The median follow-up time corresponded to the hospital stay - 9.5 days. To identify cardiac arrhythmias, regular daily ECG recording in 12 leads was initiated from the first day after TAP-AVI. In the presence of palpitations, 24-hour ECG monitoring was performed. Indicators such as age, male gender, DM, history of AF, interatrial block before surgery, CAD, and echocardiographic parameters were studied as possible predictors of AF development in the early postoperative period after TAP-AVI. There were no significant differences in the baseline parameters in patients with AF paroxysms and sinus rhythm. Results.  In the early postoperative period, AF was encountered in 46 (39%) of patients. New-onset AF occurred in 38 (32.2%) patients. No cerebrovascular event occurred in patients with post-surgery AF. The only statistically significant risk factor for AF in the postoperative period was CAD (OR 5.756; 95% CI 1.009-8.132; p = 0.048). Conclusion.  In the early postoperative period, the only significant predictor of AF was the presence of documented CAD.