Left lobectomy might be a risk factor for atrial fibrillation following pulmonary lobectomy

• Published in: European journal of cardio-thoracic surgery Vol. 45; no. 2; pp. 247 - 250
• Main Authors: Xin, Yanzhong, Hida, Yasuhiro, Kaga, Kichizo, Iimura, Yasuaki, Shiina, Nobuyuki, Ohtaka, Kazuto, Muto, Jun, Kubota, Suguru, Matsui, Yoshiro
• Format: Journal Article
• Language: English
• Published: Germany Oxford University Press 01.02.2014
• Subjects: Aged; Atrial Fibrillation - blood; Atrial Fibrillation - etiology; Chi-Square Distribution; Female; Humans; Lung Neoplasms - blood; Lung Neoplasms - surgery; Male; Middle Aged; Multivariate Analysis; Natriuretic Peptide, Brain - blood; Pneumonectomy - adverse effects; Predictive Value of Tests; Risk Factors; ROC Curve; B-type natriuretic peptide; Arrhythmia; Lobectomy; Lung cancer; Atrial fibrillation; Surgery
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezt383

OBJECTIVE To identify risk factors for atrial fibrillation (AF) following lobectomy for a pulmonary malignant tumour. METHODS The outcomes of patients who underwent lobectomy from February 2005 to September 2010 were analysed with respect to the development of postoperative AF. RESULTS Among 186 patients, 20 developed AF and these had significantly higher preoperative B-type natriuretic peptide (BNP) than those without AF. A significantly high incidence of AF following pulmonary lobectomy was demonstrated in the group of patients who were male, underwent a thoracotomy, had a high preoperative value of BNP and underwent a left lobectomy. Multivariate analysis revealed that left lobectomy is the only independent risk factor. The area under the receiver-operating characteristic curve for BNP to predict postoperative AF following a left lobectomy for a pulmonary malignant tumour was 0.82 (95% confidence interval 0.70-0.93; P < 0.05). A BNP level of 24.1 pg/ml had a sensitivity of 90.9% and a specificity of 56% for predicting postoperative AF following left lobectomy for a pulmonary malignant tumour. CONCLUSIONS Left lobectomy is the only independent risk factor for postoperative AF. Elevated BNP is the risk factor for postoperative AF in patients undergoing left pulmonary lobectomy.