| Abstract [eng] |
Practical value of the study. Postoperative atrial fibrillation is the most common cardiac rhythm disorder developing after cardiac surgery, associated with worse clinical outcomes and a greater economic burden on the healthcare system. The literature indicates that postoperative atrial fibrillation develops in 20-50% of patients after cardiac surgery. Due to the high burden of these complications, various prophylactic strategies are being developed in clinical practice, which most often include the prophylactic administration of antiarrhythmic drugs, however, to date, no universal protocol for pharmacological prophylaxis has been established. Aim of the study. To determine the incidence of postoperative atrial fibrillation after cardiac surgical intervention, to evaluate risk factors associated with its development, and to investigate the characteristics of prophylactic antiarrhythmic drug use in patients after cardiac surgery in the intensive care unit. Objectives of the study: 1. To determine the incidence of postoperative atrial fibrillation in patients after cardiac surgery in the intensive care unit; 2. To determine risk factors associated with postoperative atrial fibrillation; 3. To evaluate the characteristics of prophylactic antiarrhythmic drug use in patients after cardiac surgery in the intensive care unit; 4. To compare demographic and clinical characteristics of patients, as well as the incidence of postoperative atrial fibrillation and characteristics of prophylaxis use, between the primary and repeated audits investigating postoperative atrial fibrillation incidence and prophylaxis use in the intensive care unit. Methodology. A retrospective clinical two-stage audit was performed. Patients data after cardiac surgery in the intensive care unit were analysed. The incidence of new postoperative atrial fibrillation, risk factors, and the application of prophylaxis were evaluated. Statistical analysis of the data was performed using RStudio (2026.01.0+392) and Microsoft Excel (16.107.1). Results. The incidence of new postoperative atrial fibrillation during the primary and repeated audits remained similar – 21.5% and 21.1%. Postoperative atrial fibrillation was more frequently registered in older patients, in the presence of increased left atrial volume, reduced glomerular filtration rate, mitral valve regurgitation, and when bicaval cannulation was applied. Prophylaxis of postoperative atrial fibrillation was applied to a limited extent – beta-blockers were administered on less than one quarter of eligible patient-days, while amiodarone was not administered prophylactically on any day. In the group without postoperative atrial fibrillation prophylaxis, the incidence of new postoperative atrial fibrillation was 21.9%, whereas in the group in which prophylaxis was applied, no new episodes were registered. Conclusions. The incidence of postoperative atrial fibrillation in the studied population corresponded to the ranges indicated in the literature – 21.1-21.5%. Risk factors for postoperative atrial fibrillation are increased left atrial volume, reduced glomerular filtration rate, mitral valve regurgitation, and bicaval cannulation during cardiac surgery. In the group in which postoperative atrial fibrillation prophylaxis was applied, no new postoperative atrial fibrillation episodes were registered, however, the data are insufficient to reliably evaluate its effectiveness. Keywords: Postoperative atrial fibrillation; cardiac surgery; risk factors; prophylaxis; beta-blockers; amiodarone. |
