Post-Cardiotomy Pericardial Effusion and Postoperative Atrial Fibrillation Risk

Abstract PurposePostoperative atrial fibrillation is a poor prognostic factor that increases mortality rates. We have observed that patients who experienced significant pericardial effusion developed postoperative atrial fibrillation; however, little research has been conducted examining the association between postoperative atrial fibrillation and post-cardiotomy pericardial effusion.MethodsThis retrospective, single-center study included adult patients who underwent cardiovascular surgery via median sternotomy from January 2016 to December 2019. Patients who underwent routine postoperative computed tomography at 7±3 days after surgery (n = 294) were included. Pericardial effusion was measured at its thickest point. Patients were classified into groups with (n = 127) and without (n = 167) postoperative atrial fibrillation, and the association of pericardial effusion with other factors was evaluated. A possible confounder adjusted logistic regression analysis after multiple imputation was performed to obtain odds ratios for postoperative atrial fibrillation using previously published risk factors.ResultsAge, intraoperative bleeding volume, and pericardial effusion size were all significantly higher in the group with postoperative atrial fibrillation. Multivariate logistic regression after multiple imputation revealed that age, intraoperative bleeding volume, and postoperative pericardial effusion were significantly associated with postoperative atrial fibrillation.ConclusionTo our knowledge, this is the first study focusing on the relationship between post-cardiotomy pericardial effusion and postoperative atrial fibrillation. Our findings showed that post-cardiotomy pericardial effusion is associated with postoperative atrial fibrillation. However, causality remains unknown, making further studies mandatory.