Predictors of conversion of atrial fibrillation after cardiac operation inthe absence of class I or III antiarrhythmic medications

Background. Although risk factors for the development of atrial fibrillatio n (AF) after cardiac operations have been studied extensively, predictors o f conversion to sinus rhythm within 24 hours of onset have not been examine d. Methods. Eleven hundred consecutive adults undergoing cardiovascular operat ions from July 1997 to June 1998 were screened for new onset AF after opera tion. Patients with chronic persistent preoperative AF or those who died wi thin 48 hours of the operation were excluded. Results. Three hundred fifty-three patients developed AF after operation; o f these, 163 received therapy only for control of ventricular response, and 131 of the 163 (80%) converted to sinus rhythm within 24 hours. Logistic r egression analysis determined that postoperative beta -blocker use before t he onset of AF, and the absence of severe LV dysfunction or diabetes, predi cted reversion to sinus rhythm. Patients who converted had a shorter hospit al stay and were more likely to be discharged in sinus rhythm. Conclusions. Atrial fibrillation resolves in most patients and it is possib le to predict in which patients resolution is most likely, based on clinica l data. (C) 2001 by The Society of Thoracic Surgeons.