Patient-Reported Atrial Fibrillation Following Septal Myectomy for Hypertrophic Cardiomyopathy.

The Annals of Thoracic Surgery
Daokun SunSteve R Ommen

Abstract

Patient-reported outcomes are important metrics of medical and surgical care. In this study, we investigated the prevalence and risk factors of patient-reported postdischarge atrial fibrillation (AF) following septal myectomy for obstructive hypertrophic cardiomyopathy. Patients undergoing transaortic septal myectomy from August 2001 to January 2017 were contacted regarding postdischarge AF through questionnaire-based surveys sent at 3, 5, and 10 years post procedure. For each patient, the most recent survey response was analyzed. Among 949 patients, 248 (26.1%) last responded at 3 years post procedure, 353 (37.2%) at 5 years, and 348 (36.7%) at 10 years. The overall incidence of patient-reported postdischarge AF was 34.4% (n=326), and at 3, 5, and 10 years, the incidences were 22.2%, 34.8%, and 42.5% (P<0.001). After multivariable adjustment, history of preoperative AF (OR 5.566, P<0.001), early postoperative AF within the first 30 days (OR 2.211, P<0.001), preoperative left atrial volume index (OR 1.014, P=0.005), postoperative right ventricular systolic pressure (OR 1.021, P=0.013), postoperative moderate or greater mitral valve regurgitation (OR 1.893, P=0.022), and preoperative septal thickness (OR 1.043, P=0.036) were ind...Continue Reading

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