Takeaway
- Coronary artery disease (CAD) and hypertension are the risk factors for the development of new-onset atrial fibrillation (Afib), which is commonly observed in patients undergoing oesophagectomy after cancer.
- Post-operative Afib is associated with an increased risk for complications and mortality.
Why this matters
- Rates of new-onset Afib as high as 40% have been reported after oesophagectomy.
Study design
- 53 studies (4 randomised controlled trials, 49 observational studies; n=9087) met eligibility criteria after a search across electronic databases.
- Primary outcomes: incidence new-onset Afib after oesophagectomy and difference in post-operative mortality between patients with and without Afib.
- Secondary outcomes: incidence of pneumonia and anastomotic leak.
- Funding: None disclosed.
Key results
- The overall incidence of post-operative Afib was 16.5% (95% CI, 15.4-17.2%).
- CAD (OR, 1.47; 95% CI, 1.07-2.02) and hypertension (OR, 2.63; 95% CI, 1.38-5.02) were associated with Afib development within 30 days after surgery.
- Patients with Afib vs those without had a significantly higher risk for:
- overall post-operative adverse events (OR, 5.40; 95% CI, 3.51-8.30);
- mortality (OR, 2.49; 95% CI, 1.70-3.64);
- anastomotic leak (OR, 2.65; 95% CI, 1.53-4.59); and
- pneumonia (OR, 3.42; 95% CI, 2.39-4.90).
Limitations
- Risk of bias.
- Study may have under-reported Afib.
References
References
