J. Mansour2, C.C. Moodie1, J.R. Garrett1, J.R. Tew1, J.J. Baldonado1,2, J.P. Fontaine1,2, E.M. Toloza1,2 1Moffitt Cancer Center And Research Institute, Thoracic Oncology, Tampa, FL, USA 2University Of South Florida College Of Medicine, Tampa, FL, USA
Introduction: Postoperative atrial fibrillation (POAF) is a common complication following pulmonary lobectomy, with potential adverse effects on patient outcomes. Identifying predictors of POAF could aid in risk stratification and preventive strategies. Resting heart rate (RHR) has been suggested as a potential predictor of POAF in pulmonary lobectomy patients. This study aimed to investigate the association between RHR and development of POAF in patients undergoing robotic-assisted pulmonary lobectomy (RAPL).
Methods: We retrospectively analyzed 719 patients who underwent RAPL by one surgeon over an 11-year period, with 188 excluded for prior history of arrythmias, leaving 531 in the final cohort. RHR was measured during preoperative evaluation within 30 days prior to RAPL. Patients were monitored postoperatively for occurrence of POAF.
Results: Among the study cohort, 95 patients (17.9%) developed new-onset POAF following RAPL. The non-POAF mean RHR was calculated as 73.8 ± 0.6 (SEM) bpm, and the POAF mean RHR was 75.9 ± 1.3 bpm. A single sample z-score of 1.71 was calculated for the POAF population, with a p-value of 0.046, which is statistically significant (p≤0.05). The sensitivity of a RHR greater than 89.5 bpm for POAF was found to be 15.8%, and the specificity was 89.2%. For patients with RHR above 89.5 bpm (n=62), the risk of POAF increased by greater than 50% (Odds Ratio = 1.55), with 24.2% developing POAF.
Conclusion: These findings suggest that preoperative RHR along with other factors may serve as a valuable tool for early identification of individuals at higher risk of developing POAF. However, further research is needed to explore potential interventions for reduction of POAF in this population.