There may be a significant ongoing risk of atrial fibrillation (AFib) in patients who undergo cardiac surgery with no history of AFib and a high risk of stroke, according to results of the SEARCH-AF trial presented Nov. 16 during AHA 2020.

Subodh Verma, MD, PhD, et al., looked at 336 post-cardiac surgery patients from eight medical centers across Canada without a previous history of AFib or atrial flutter (AFL) and at a high risk of stroke. Patients were randomized to receive 30 days of noninvasive continuous electrocardiography monitoring through an adhesive, patch-based monitor worn on their chest vs. usual care.

Results showed that the primary endpoint of cumulative AFib or AFL ≥6 minutes documented by monitoring or by a 12-lead ECG within 30 days of randomization was detected in 32 patients (19.6%) from the monitoring group vs. in three patients (1.7%) in the usual care group.

Further, in the monitoring group, AFib was detected at a rate 10 times higher than in those who received usual care.

The authors conclude that their "strategy of continuous rhythm monitoring unveiled a significant persistent burden of unrecognized and potentially actionable AFib."

"Our study points to the fact that post-operative AFib is not self-limited to hospital stay per se. A significant risk of post-operative AFib persists even in those patients without any preoperative or pre-discharge AFib," Verma explains. "These data may help inform physicians about the importance of surveillance and vigilance in patients at high risk of stroke with respect to monitoring and prompt treatment for AFib."

Clinical Topics: Arrhythmias and Clinical EP, Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Cardiac Surgery and Arrhythmias

Keywords: AHA Annual Scientific Sessions, AHA20, Atrial Fibrillation, Arrhythmias, Cardiac, Cardiac Surgical Procedures

< Back to Listings