Atrial fibrillation after lung cancer surgery: incidence, severity, and risk factors

Surg Today. 2017 Feb;47(2):252-258. doi: 10.1007/s00595-016-1380-y. Epub 2016 Jul 6.

Abstract

Purpose: Atrial fibrillation (Af) is a common post-operative cardiac complication after lung cancer surgery; however, the type of lung cancer surgery being performed has evolved, remarkably, into minimally invasive surgical procedures. The purpose of this study was to quantify the incidence and severity of post-operative Af and to identify the risk factors for Af, using a recent cohort of lung cancer surgery patients.

Methods: We reviewed, retrospectively, the medical records of 593 patients, who underwent lung cancer surgery between 2011 and 2013, for the development of post-operative Af.

Results: The overall incidence of post-operative Af in our study was 6.4 % (38/593). Three (8 %) of these 38 patients, subsequently, suffered brain infarction. Multivariate analysis revealed that mediastinal lymph node dissection (OR ND-2/ND-0-1 = 3.06; 95 % CI 1.06-10.9) was associated with the development of post-operative Af.

Conclusion: Omission of mediastinal lymph dissection for patients with early stage lung cancer and a high risk of Af should be considered to prevent post-operative Af.

Keywords: Atrial fibrillation; Brain infarction; Complication; Lung cancer; Surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / epidemiology*
  • Atrial Fibrillation / etiology*
  • Atrial Fibrillation / prevention & control
  • Cerebral Infarction / epidemiology
  • Cerebral Infarction / etiology
  • Cohort Studies
  • Contraindications
  • Female
  • Humans
  • Incidence
  • Lung Neoplasms / surgery*
  • Lymph Node Excision / adverse effects*
  • Male
  • Middle Aged
  • Organ Sparing Treatments
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology*
  • Postoperative Complications / prevention & control
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Thoracic Surgery, Video-Assisted