Atrial fibrillation after lung surgery: incidence, underlying factors, and predictors

Introduction
Cardiac complications are the second most common cause of morbidity and mortality in patients subjected to thoracic surgery after respiratory complications. Postoperative arrhythmia is one of the most common cardiac complications in these patients. It leads to morbidity, increased hospitalization, and high costs for patients.

Aim
To determine the incidence of atrial fibrillation after lung resection and determine the underlying factors and predictors of this problem.

Material and methods
The participants in this study were composed of all patients who were subjected to lung resection surgery in the past 4 years. The demographic data of the patients and possible postoperative complications, including the incidence of atrial fibrillation, were extracted from patient records. The statistical analysis of data was performed after data collection.

Results
The incidence of postoperative atrial fibrillation (POAF) in the present study was 7.6% (n = 20), mostly in patients who had a lung parenchyma resection. It occurred due to malignancy (n = 16), squamous cell carcinoma (n = 9), adenoid cystic carcinoma (n = 5), and metastasis (n = 2). The POAF occurred in 34.2% of pneumonectomy cases and 4.5% of lobectomy cases, out of whom 60% were male. There was a significant difference between the two groups of arrhythmia and non-arrhythmia groups regarding the age range. The mean ages of patients with and without arrhythmias were 56.45 ±18.2 and 44.76 ±17.2, respectively.

Conclusions
Pulmonary malignant pathologies are more likely to develop POAF due to the need for lung resection and possibly mediastinal lymphadenectomy that stimulates the heart and pericardium and the vagus nerve.