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Scoring system for predicting the Post-Operative Atrial Fibrillation (POAF) in post-cardiac surgery: a literature review

Abstract

Link of Video Abstract: https://youtu.be/tl9Q8g6DUdc

Background:
Coronary artery bypass grafting (CABG) is still one of the optimal treatment options for revascularization in coronary heart disease. Despite Atrial Fibrillation being the most common arrhythmia after CABG, there’s still no agreement on which risk assessment to predict the incidence of Post Operative Atrial Fibrillation (POAF).  Some studies have shown that the findings of Atrial fibrillation after CABG are associated with increased hemodynamic disturbances, thromboembolic manifestations, readmission to the Intensive Care Unit (ICU), increased length of stay, organ failure, and death. This study aims to analyze the scoring system used for predicting the incidence of POAF in cardiac surgery.

Methods:  This study used “POAF” AND “Scoring system," AND "CABG” AND “Atrial Fibrillation” as keywords to explore the literature from PubMed, Google Scholar, ProQuest, and Clinical Key. Search engines were searched for relevant papers from the last 15 years.

Result: CHA2DS2-VASc score has a sensitivity of 74.2%, a specificity of 44.7% and can identify patients who are predicted to have a high risk of experiencing POAF by 49.4%. The CHA2DS2-VASc score can be used as an independent predictor for predicting POAF. HATCH score cut-off point exceeding 1 was linked to AF prediction, yielding a sensitivity of 42% and specificity of 70%. POAF Score, the scoring system anticipates an increased likelihood of POAF development (58.5%). A score of 1 corresponds to a 30.1% probability of POAF occurrence and is a practical point for commencing preventive therapy.

Conclusion: Despite the various scoring systems used to predict postoperative atrial fibrillation, including the CHA2DS2-VASc score, HATCH score and Mariscalco. POAF Score demonstrated a validated ability to predict POAF.

References

  1. Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Ganiats TG, Holmes DR, et al. 2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology. 2014;64(24):e139-e228.
  2. Burgos LM, Ramirez AG, Seoane L, Furmento JF, Costabel JP, Diez M, et al. New Combined Risk Score to Predict Atrial Fibrillation after Cardiac Surgery: COM-AF. Ann Card Anaesth. 2021;24(4): 458–463.
  3. Chen L, Du X, Dong J, Ma C. Performance and validation of a simplified postoperative atrial fibrillation risk score. Wiley Online Library. 2018;41(9):1136-1142.
  4. Gorczyca I, Mitchta K, Pietrzyk E, Wozakowska-Kapton B. Predictors of post-operative atrial fibrillation in patients undergoing isolated coronary artery bypass grafting. Kardio Pol. 2018;76(1):195-201.
  5. de Vos CB, Pisters R, Nieuwlaat R, Prins MH, Tieleman RG, Coelen RJ, et al. Progression from paroxysmal to persistent atrial fibrillation clinical correlates and prognosis. J Am Coll Cardiol. 2010;55(8):725-731.
  6. Dobrev D, Aguilar M, Heijman J, Guichard J, Nattel S. Postoperative atrial fibrillation:mechanisms, manifestations and management. Nature Reviews Cardiology. 2019;16(7):417-436.
  7. Mariscalco G, Biancari F, Zanobini M, Cottini M, Piffaretti G, Saccocci M, et al. Bedside tool for predicting the risk of postoperative atrial fibrillation after cardiac surgery: the POAF score. Journal of the American Heart Association. 2014;3(2):e000752.
  8. Kolh P, Windecker S, Alfonso F, Collet J, Cremer J, Falk V, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization. European Journal of Cardio-thoracic Surgery. 2014;46(4):517-592.
  9. Gruberg L. Hellkamp AS, Thomas LE, de Lemos JA, Scirica BM, Hilliard A, et al. The Association of Previous Revascularization With In-Hospital Outcomes in Acute Myocardial Infarction Patients. JACC: Cardiovascular Interventions. 2015;8(15):1954–1962.
  10. Hung LT, Alshareef A, Al-Ahdal TMA, Anh PTT, Huann DG, Trang DV, et al. Predicting Atrial Fibrillation After Cardiac Surgery Using a Simplified Risk Index. J electrocardiol. 2021;67(1): 45-49.
  11. Kashani RG, Sareh S, Genovese B, Hershey C, Rezentes C, Shemin R, et al. Predicting postoperative atrial fibrillation using CHA2DS2-VASc scores. J Surg Res. 2015;198(2):267-272.
  12. Kouchoukos NT. What is a Cardiothoracic Surgical "Center of Excellence"?. Ann Thorac Surg. 2016;102(5):1426-1427.
  13. Braunwald E. Heart failure. JACC Heart Fail. 2013;1(1):1-20.
  14. Selvi M, Gungor H, Zencir C, Gulasti S, Eryilmaz U. A new predictor of atrial fibrillation after coronary artery bypass graft surgery: HATCH score. J Investig Med. 2018;66(3):648-652.
  15. Suenari K, Chao T, Liu C, Kihara Y, Chen T, Chen S. Usefulness of HATCH score in the prediction of new-onset atrial fibrillation for Asians. Medicine (Baltimore). 2017;96(1):e5597.
  16. Heidari A, Firoozabadi MD, Sheikhi MA. Postoperative Bleeding in CABG Patients: New Study in Southwest of Iran. Bali Medical Journal. 2016;5(3):400–403.
  17. Firoozabadi MD, Ebadi A, Sheikhi MA. Extubation time and postoperative blood pressure in CABG patient. Bali Medical Journal. 2017;6(1):186–191.
  18. Citradinata C, Widyastiti NS. The relationship of lactic acid, neutrophil lymphocyte ratio and monocyte lymphocyte ratio with the outcomes of coronary arterial disease patients following coronary artery bypass surgery. Bali Medical Journal. 2019;8(2):455–459.
  19. Bhargah A, Jayantika IGABK, Prabawa IPY, Manuaba IBP. Spontaneous conversion to sinus rhythm in atrial fibrillation after dual antiplatelet and anticoagulant therapy in patients with unstable angina. Bali Medical Journal. 2020;9(3):664-667.
  20. Seo EJ, Hong J, Lee H, Son Y. Perioperative risk factors for new-onset postoperative atrial fibrillation after coronary artery bypass grafting: a systematic review. BMC Cardiovascular Disorders. 2021;21(1):1-11.
  21. Stefàno PL, Bugetti M, Monaco GD, Popescu G, Pieragnoli P, Ricciardi G, et al. Overweight and aging increase the risk of atrial fibrillation after cardiac surgery independently of left atrial size and left ventricular 42 ejection fraction. Journal of Cardiothoracic Surgery. 2020;15(1):1-5.
  22. Goudis CA. Chronic obstructive pulmonary disease and atrial fibrillation: An unknown relationship. Journal of Cardiology. 2017;69(5):699-705.
  23. Pieri M, Belletti A, Monaco F, Pisano A, Musu M, Dalessandro V, et al. Outcome of cardiac surgery in patients with low preoperative ejection fraction. BMC Anesthesiology. 2016;16(1):1-10.
  24. Perrier S, Meyer N, Minh TH, Mommerot A. Predictors of Atrial Fibrillation After Coronary Artery Bypass Grafting: A Bayesian Analysis. The Annals of Thoracic Surgery. 2017;103(1):92–97.
  25. Zaman AG, Archbold RA, Helfy G, Paul EA, Curzen NP, Mills PG. Atrial Fibrillation After Coronary Artery Bypass Surgery. Circulation. 2000;101(12):1403–1408.

How to Cite

Puspitasari, R. A., Sembiring, Y. E., & Sembiring, J. A. (2023). Scoring system for predicting the Post-Operative Atrial Fibrillation (POAF) in post-cardiac surgery: a literature review. Bali Medical Journal, 12(3), 2936–2942. https://doi.org/10.15562/bmj.v12i3.4801

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Rahajeng Arianggarini Puspitasari
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Pubmed
BMJ Journal


Yan Efrata Sembiring
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BMJ Journal


Joan Angelina Sembiring
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Pubmed
BMJ Journal