scholarly journals Association of Heart Rate Variability With Silent Brain Infarcts in Patients With Atrial Fibrillation

2021 ◽  
Vol 8 ◽  
Author(s):  
Peter Hämmerle ◽  
Christian Eick ◽  
Sven Poli ◽  
Steffen Blum ◽  
Vincent Schlageter ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Autonomic Dysfunction ◽  
Brain Mri ◽  
Low Frequency ◽  
Total Power ◽  
Brain Infarcts ◽  
Clinical Covariates ◽  
Prior Stroke ◽  
Mean Heart Rate

Purpose: Silent brain infarcts (SBI) are frequently detected in patients with atrial fibrillation (AF), but it is unknown whether SBI are linked to autonomic dysfunction. We aimed to explore the association of autonomic dysfunction with SBI in AF patients.Methods: 1,358 AF patients without prior stroke or TIA underwent brain MRI and 5-min resting ECG. We divided our cohort into AF patients who presented in sinus rhythm (SR-group, n = 816) or AF (AF-group, n = 542). HRV triangular index (HRVI), standard deviation of normal-to-normal intervals, mean heart rate, root mean square root of successive differences of normal-to-normal intervals, 5-min total power and power in the low frequency, high frequency and very low frequency range were calculated. Primary outcome was presence of SBI in the SR group, defined as large non-cortical or cortical infarcts. Secondary outcomes were SBI volumes and topography.Results: Mean age was 72 ± 9 years, 27% were female. SBI were detected in 10.5% of the SR group and in 19.9% of the AF group (p < 0.001). HRVI <15 was the only HRV parameter associated with the presence of SBI after adjustment for clinical covariates in the SR group [odds ratio (OR) 1.67; 95% confidence interval (CI): 1.03–2.70; p = 0.037]. HRVI <15 was associated with larger brain infarct volumes [β (95% CI) −0.47 (−0.84; −0.09), p = 0.016] in the SR group and was more frequently observed in patients with right- than left-hemispheric SBI (p = 0.017).Conclusion: Impaired HRVI is associated with SBI in AF patients. AF patients with autonomic dysfunction might undergo systematic brain MRI screening to initiate intensified medical treatment.Clinical Trials Gov Identifier: NCT02105844.

scholarly journals The Influence ofNrf2on Cardiac Responses to Environmental Stressors

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Reuben Howden ◽  
Eva Gougian ◽  
Marcus Lawrence ◽  
Samantha Cividanes ◽  
Wesley Gladwell ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Low Frequency ◽  
Therapeutic Strategies ◽  
Environmental Stressors ◽  
Total Power ◽  
Airborne Pollutants ◽  
Cardiac Responses

Nrf2protects the lung from adverse responses to oxidants, including 100% oxygen (hyperoxia) and airborne pollutants like particulate matter (PM) exposure, but the role ofNrf2on heart rate (HR) and heart rate variability (HRV) responses is not known. We hypothesized that genetic disruption ofNrf2would exacerbate murine HR and HRV responses to severe hyperoxia or moderate PM exposures.Nrf2-/-andNrf2+/+mice were instrumented for continuous ECG recording to calculate HR and HRV (low frequency (LF), high frequency (HF), and total power (TP)). Mice were then either exposed to hyperoxia for up to 72 hrs or aspirated with ultrafine PM (UF-PM). Compared to respective controls, UF-PM induced significantly greater effects on HR (P<0.001) and HF HRV (P<0.001) inNrf2-/-mice compared toNrf2+/+mice.Nrf2-/-mice tolerated hyperoxia significantly less thanNrf2+/+mice (~22 hrs;P<0.001). Reductions in HR, LF, HF, and TP HRV were also significantly greater inNrf2-/-compared toNrf2+/+mice (P<0.01). Results demonstrate thatNrf2deletion increases susceptibility to change in HR and HRV responses to environmental stressors and suggest potential therapeutic strategies to prevent cardiovascular alterations.

Abstract P315: Increase in Stress May Contribute to Lower Heart Rate Variability in Healthy Young Subjects

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Amanda C Costa ◽  
Ana Gabriela C Silva ◽  
Cibele T Ribeiro ◽  
Guilherme A Fregonezi ◽  
Fernando A Dias
Keyword(s):  
Cardiovascular Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Healthy Volunteers ◽  
Perceived Stress ◽  
Low Frequency ◽  
Statistical Correlation ◽  
Total Power ◽  
The Impact ◽  
Nonparametric Correlation

Background: Stress is one of the risk factors for cardiovascular disease and decreased heart rate variability is associated to increased mortality in some cardiac diseases. The aim of the study was to assess the impact of perceived stress on cardiac autonomic regulation in young healthy volunteers. Methods: 35 young healthy volunteers (19 to 29 years old, 6 men) from a Brazilian population were assessed for perceived stress by the translated and validated Perceived Stress Scale (PSS, 14 questions) and had the R-R intervals recorded at rest on supine position (POLAR RS800CX) and analyzed (5 minutes, Kubius HRV software) by Fast-Fourier Transform for quantification of Heart Rate Variability (HRV). Results: Average data (±SD) for age, heart rate, BMI, waist circumference and percentage of body fat (%BF) were: 21.3±2.7 years; 65.5±7.9 bpm; 22.3±1.9 Kg/m 2 ; 76.0±6.1 cm and 32.1±6.6%; respectively. The mean score for the PSS-14 was 23.5±7.2 and for the HRV parameter as follow: SSDN=54.8±21.2ms; rMSSD=55.9±32.2ms; low-frequency (LF)= 794.8±579.7ms 2 ; High-frequency (HF)= 1508.0±1783.0 ms 2 ; LF(n.u.)= 41.1±16.2; HF(n.u.)= 58.9±16.2; LF/HF=0.89±0.80 and Total power (TP)= 3151±2570ms 2 . Spearman nonparametric correlation was calculated and there was a significant correlation of PSS-14 scores and LF (ms 2 ) (r=−0.343; p= 0.044). Other HRV variables did not shown significant correlation but also had negative values for Spearman r (TP r=−0.265, p=0.124; HF r=−0.158; SSDN r=−0.207; rMSSD r=−0.243, p=0.160). LF/HF and LF(n.u.) did not correlate to PSS-14 having Spearman r very close to zero (LF/HF r=−0.007, p=0.969; LF(n.u.) r=−0.005, p=0.976). No correlation was found for HRV parameters and BMI and there was a trend for statistical correlation of %BF and LF (ms 2 ) (r=−0.309, p=0.071). Conclusions: These data demonstrate a possible association of perceived stress level and HRV at rest. Changes in LF can be a consequence of both sympathetic and parasympathetic activity, however, analyzing the other variables HF, TP, SSDN and rMSSD (all negative Spearman r) and due to the lack of changes in LF/HF ratio and LF(n.u.) we interpret that increased stress may be associated to decrease in overall heart rate variability. These changes were seen in healthy individuals and may point out an important mechanism in cardiovascular disease development.

scholarly journals Heart Rate Variability and Cardiovascular Reflex Tests for Assessment of Autonomic Functions in Preeclampsia

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Meenakshi Chaswal ◽  
Raj Kapoor ◽  
Achla Batra ◽  
Savita Verma ◽  
Bhupendra S. Yadav
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Pregnant Women ◽  
Frequency Domain ◽  
Low Frequency ◽  
Normal Pregnancy ◽  
Total Power ◽  
Autonomic Functions ◽  
Cardiovascular Reflex ◽  
Cardiovascular Reflex Tests

Alterations in the autonomic cardiovascular control have been implicated to play an important etiologic role in preeclampsia. The present study was designed to evaluate autonomic functions in preeclamptic pregnant women and compare the values with normotensive pregnant and healthy nonpregnant controls. Assessment of autonomic functions was done by cardiovascular reflex tests and by analysis of heart rate variability (HRV). Cardiovascular reflex tests included deep breathing test (DBT) and lying to standing test (LST). HRV was analyzed in both time and frequency domain for quantifying the tone of autonomic nervous system to the heart. The time domain measures included standard deviation of normal R-R intervals (SDNN) and square root of mean squared differences of successive R-R intervals (RMSSD). In the frequency domain we measured total power (TP), high frequency (HF) power, low frequency (LF) power, and LF/HF ratio. Cardiovascular reflex tests showed a significant parasympathetic deficit in preeclamptic women. Among parameters of HRV, preeclamptic group had lower values of SDNN, RMSSD, TP, HF, and LF (ms2) and higher value of LF in normalised units along with high LF/HF ratio compared to normotensive pregnant and nonpregnant controls. Furthermore, normotensive pregnant women had lower values of SDNN, TP, and LF component in both absolute power and normalised units compared to nonpregnant females. The results confirm that normal pregnancy is associated with autonomic disturbances which get exaggerated in the state of preeclampsia.

P3712The omega-3 fatty acid eicosapentaenoic acid (EPA) is inversely associated with ischemic brain infarcts in elderly patients with atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M F Reiner ◽  
P Baumgartner ◽  
A Wiencierz ◽  
S Aeschbacher ◽  
N Rodondi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Elderly Patients ◽  
Eicosapentaenoic Acid ◽  
Brain Mri ◽  
Omega 3 ◽  
Total N ◽  
Stroke Incidence ◽  
Ischemic Brain ◽  
Brain Infarcts

Abstract Background The association of individual omega-3 fatty acids (n-3 FAs) with ischemic stroke remains unclear. Experimental data strongly suggest that n-3 FAs reduce ischemic stroke due to their anti-thrombotic and anti-inflammatory properties. Yet, recent clinical trials yielded mixed results. While marine n-3 FA supplementation (1g/day) did not reduce stroke, icosapent ethyl, a purified eicosapentaenoic acid (EPA) ethyl ester (4g/day), significantly reduced stroke incidence in patients at high cardiovascular risk. In the current study, we examined the association of fish-derived EPA, docosapentaenoic acid (DPA), docosahexaenoic acid (DHA) and the plant-derived alpha-linolenic acid (ALA) with the prevalence of ischemic brain infarcts in elderly patients with atrial fibrillation. Methods In this cross-sectional analysis of the Swiss atrial fibrillation (swissAF) cohort study, we determined baseline whole blood n-3 FAs by gas chromatography according to the HS-Omega-3 Index methodology in 1665 patients aged ≥65 years with atrial fibrillation. Large non-cortical and cortical infarcts (LNCCI) were assessed by brain MRI. Total and individual n-3 FAs were correlated with the prevalence of LNCCI in a logit model with continuous factors. Analyses were adjusted for sex, age, body mass index, smoking, alcohol intake, family history of cardiovascular disease and atrial fibrillation, physical activity, hypertension, diabetes, chronic kidney disease, prior stroke, prior transient ischemic attack, aspirin, anticoagulation and type of atrial fibrillation. Results A total of 373 patients with LNCCI (22.4%) were identified. After adjustment, lower risk of LNCCI was associated with higher EPA (odds ratio [OR] 0.50 per increase of one percentage point EPA, 95% confidence interval [CI] 0.28–0.88) and a higher risk was detected with DPA (OR 2.39, 95% CI 1.43–4.01). No statistically significant association was detected with DHA (OR 1.13, 95% CI 0.94–1.35), ALA (OR 0.83, 95% CI 0.23–2.95) or total n-3 FAs (OR 1.03, 95% CI 0.92–1.16). Conclusions Higher levels of EPA are associated with a lower prevalence of ischemic infarcts in aged patients with atrial fibrillation. Unexpectedly, DPA shows a direct correlation with ischemic infarcts. This study demonstrates that individual n-3 FAs may differentially affect stroke risk and that supplementation of EPA may be an interesting strategy to prevent ischemic stroke in atrial fibrillation patients. Acknowledgement/Funding Swiss National Science Foundation

Elevated heart rate variability in physically active postmenopausal women: a cardioprotective effect?

1996 ◽  
Vol 271 (2) ◽  
pp. H455-H460 ◽  
Author(s):  
K. P. Davy ◽  
N. L. Miniclier ◽  
J. A. Taylor ◽  
E. T. Stevenson ◽  
D. R. Seals
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Postmenopausal Women ◽  
High Frequency ◽  
Low Frequency ◽  
Total Power ◽  
High Frequency Power ◽  
Fat Percentage ◽  
Physically Active ◽  
Frequency Power

Coronary heart disease (CHD) and cardiac sudden death (CSD) incidence accelerates after menopause, but the incidence is lower in physically active versus less active women. Low heart rate variability (HRV) is a risk factor for CHD and CSD. The purpose of the present investigation was to test the hypothesis that HRV at rest is greater in physically active compared with less active postmenopausal women. If true, we further hypothesized that the greater HRV in the physically active women would be closely associated with an elevated spontaneous cardiac baroreflex sensitivity (SBRS). HRV (both time and frequency domain measures) and SBRS (sequence method) were measured during 5-min periods of controlled frequency breathing (15 breaths/min) in the supine, sitting, and standing postures in 9 physically active postmenopausal women (age = 53 +/- 1 yr) and 11 age-matched controls (age = 56 +/- 2 yr). Body weight, body mass index, and body fat percentage were lower (P < 0.01) and maximal oxygen uptake was higher (P < 0.01) in the physically active group. The standard deviation of the R-R intervals (time domain measure) was higher in all postures in the active women (P < 0.05) as were the high-frequency, low-frequency, and total power of HRV. SBRS also was higher (P < 0.05) in the physically active women in all postures and accounted for approximately 70% of the variance in the high-frequency power of HRV (P < 0.05). The results of the present investigation indicate that physically active postmenopausal women demonstrate higher levels of HRV compared with age-matched, less active women. Furthermore, SBRS accounted for the majority of the variance in the high-frequency power of HRV, suggesting the possibility of a mechanistic link with cardiac vagal modulation of heart rate. Our findings may provide insight into a possible cardioprotective mechanism in physically active postmenopausal women.

NEUROCARDIAC-CARDIORESPIRATORY INTERACTION OF HEART-BRAIN MAILUNS SYNCHRONY AT DEEP ZEN MEDITATION

2016 ◽  
Vol 28 (06) ◽  
pp. 1650039
Author(s):  
Pei-Chen Lo ◽  
Wu Jue Miao Tian
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Low Frequency ◽  
Transition Process ◽  
Total Power ◽  
Sinus Arrhythmia ◽  
Respiration Rhythm ◽  
Scientific Hypothesis ◽  
Cardiorespiratory Interaction ◽  
Electrical Impulses

Innovatively new behaviors of heart rate variability caused by special heart-transition process were observed in the long-term, well-experienced Zen practitioners while practicing the heart-to-heart imprint sealing (HHIS) Zen meditation. HHIS Zen practice involves specific neurocardiac-cardiorespiratory interaction while on the way of realizing the heart-dominant, detached brain. Results of analyzing the electrocardiogram and respiratory signals of 10 experienced practitioners reveal several distinctive characteristics: (1) remarkably linear correlation between standard deviation of the normal R-to-R intervals, SDNN, and total power in very-low-frequency (VLF, 0.0033–0.04[Formula: see text]Hz) band of power spectrum of the heart-rate sequence, (2) time-varying VLF power dominating over the low-frequency and high-frequency power in heart rate variability (HRV) variations, (3) intermittent transition into slowly, deeply abdominal respiration inducing a boost of heart rates, (4) heart-rate baseline slowly fluctuating at 0.005–0.0067[Formula: see text]Hz, about 1.5–2 cycles in 5-min period, and (5) remarkable respiratory sinus arrhythmia (RSA) synchrony between heart rate and respiration rhythm. This paper proposes a rational scientific hypothesis for the neurocardiac-cardiorespiratory mechanism. The unique scheme of HHIS Zen meditation involves the spiritual-qi concentration and refinement for pinpointing into the particular energy centers, mailuns. Ignition by a subtle, deepest abdominal respiration, electrical impulses rapidly transmit from solar plexus to branchial plexuses to activate unique heart-transition process. Simultaneously, another branch streams upward the spinal cord to cervical plexus and brainstem that effectively harmonizes neurocardiac interactions. To investigate the underlying behaviors, time-domain and frequency-domain HRV based on continuous wavelet transform were employed.

scholarly journals Influence of heart failure severity on heart rate variability

2005 ◽  
Vol 133 (11-12) ◽  
pp. 484-491 ◽  
Author(s):  
Danijela Zamaklar-Trifunovic ◽  
Petar Seferovic ◽  
Mirjana Zivkovic ◽  
Vera Jelic ◽  
Goran Vukomanovic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Nyha Class ◽  
Low Frequency ◽  
Total Power ◽  
Pump Failure ◽  
Spectral Components ◽  
Failure Severity ◽  
Heart Failure Severity

Introduction. Autonomic regulation of cardiovascular functions in congestive heart failure is characterised by enhanced sympathetic and diminished parasympathetic activity. The long term predominance of sympathetic tone is a significant factor in arrhythmogenesis, sudden cardiac death, and progressive pump failure. Heart rate variability (HRV) is a noninvasive method for estimating the sympatho vagal balance in cardiovascular control. Aim. The aim of this study was to analyse the influence of heart failure severity on HRV. Method. HRV was estimated through the spectral analysis of short term ECG (Cardiovit AT 60, Schiller, CH) in 63 patients (78% male, mean age 56.9?10.9 years) and 14 healthy volunteers (57.1% male, mean age 53.1?8.2 years). The following spectral components were measured: VLF (very low frequency), LF (low frequency), HF (high frequency), and total power (Tot Power). Results. All spectral components were statistically, significantly lower in patients with heart failure in comparison to healthy controls (VLF: 159.89?147.02 vs. 285.50?202.77 ms2; p=0.023, LF: 161.48?204.01 vs. 474.57?362.93 ms2; p<0.001, HF: 88.58?102.47 vs. 362.71?318.28 ms2; p<0.001), as well as total power (Tot Power: 723.39?644.52 vs. 1807.29?1204.74 ms2; p<0.001). A significant, negative correlation between HRV parameters and NYHA class was detected in heart failure patients (VLF: r=-0.391; p=0.002, LF: r=-0.401; p=0.001, and Tot Power r=-0.372; p=0.003). Ejection fraction proved to be in significant, positive correlation to VLF (r=0.541; p=0.002), LF (r=0.531; p=0.003), HF (r=0.418; p=0.020), and Tot Power (r=0.457; p=0.013). Conclusion. Significant HRV reduction is a precursor to incipient heart failure (NYHA I). In heart failure progression, total power as well as the power of all spectral components is progressively reduced. LF and Tot Power are the most prominent parameters for discriminating between the different stages of heart failure. These results could promote HRV as an important decision-making tool in heart failure treatment as well as in monitoring the results of that treatment.

Impaired heart rate variability triangular index to identify clinically silent strokes in patients with atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Haemmerle ◽  
C Eick ◽  
A Bauer ◽  
K.D Rizas ◽  
M Coslovsky ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Transient Ischemic Attack ◽  
Brain Mri ◽  
Binary Logistic Regression ◽  
Funding Source ◽  
Logistic Regression Models ◽  
History Of ◽  
Ischemic Attack

Abstract Introduction The identification of clinically silent strokes in patients with atrial fibrillation (AF) is of high clinical relevance as they have been linked to cognitive impairment. Overt strokes have been associated with disturbances of the autonomic nervous system. Purpose We therefore hypothesize that impaired heart rate variability (HRV) can identify AF patients with clinically silent strokes. Methods We enrolled 1358 patients with AF without a history of stroke or transient ischemic attack from the multicenter SWISS-AF cohort study who were in sinus rhythm (SR-group, n=816) or AF (AF-group, n=542) on a 5 minute resting ECG recording. HRV triangular index (HRVI), the standard deviation of normal-to-normal intervals (SDNN) and the mean heart rate (MHR) were calculated. Brain MRI was performed at baseline to assess the presence of large non-cortical or cortical infarcts, which were considered silent strokes without history of stroke or transient ischemic attack. We constructed binary logistic regression models to analyze the association between HRV parameters and silent strokes. Results At baseline, silent strokes were detected in 10.5% in the SR group and 19.9% in the AF group. In the SR-group, HRVI &lt;15 was the only parameter independently associated with the presence of silent strokes (odds ratio (OR) 1.69; 95% confidence interval (CI): 1.04–2.72; p=0.033) after adjustment for various clinical covariates (age, sex, systolic blood pressure, history of hypertension, history of diabetes, history of heart failure, prior myocardial infarction, prior major bleeding, intake of oral anticoagulation, antiarrhythmics or betablockers). Similarly, in the AF-group, HRVI&lt;15 was independently associated with the presence of silent strokes (OR 1.65, 95% CI: 1.05–2.57; p=0.028). SDNN&lt;70ms and MHR&lt;80 were not associated with silent strokes, neither in the SR group, nor in the AF group (Figure). Conclusions Reduced HRVI is independently associated with the presence of clinically silent strokes in an AF population, both when assessed during SR and during AF. Our data suggest that a short-term measurement of HRV in routine ECG recordings might contribute to identifying AF patients with clinically silent strokes. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Swiss National Science Foundation

Role of cardiac output in mediating arterial blood pressure oscillations

1996 ◽  
Vol 271 (3) ◽  
pp. R641-R646 ◽  
Author(s):  
D. S. O'Leary ◽  
D. J. Woodbury
Keyword(s):  
Heart Rate ◽  
Cardiac Output ◽  
Low Frequency ◽  
Left Ventricular ◽  
Right Atrial ◽  
Total Power ◽  
Av Block ◽  
Arterial Blood ◽  
Low Frequency Oscillations

The objective of this study was to determine the role of cardiac output in mediating spontaneous fluctuations in mean arterial pressure (MAP) conscious dogs. Dogs were chronically instrumented to monitor MAP and cardiac output. Atrioventricular (AV) block was induced, and left ventricular and right atrial electrodes were implanted. After recovery, MAP was observed for 5 min under two conditions: 1) normal variation in heart rate and cardiac output via triggering the ventricular stimulator with each atrial depolarization (effectively reversing the AV block, AV-linked stimulation) and 2) computer control of ventricular rate to maintain cardiac output constant on a by-beat basis at the same level as observed during normal variations in heart rate and cardiac output. When cardiac output was held constant, large-amplitude, low-frequency oscillations in MAP were readily apparent. Spectral analysis by fast Fourier transform revealed that during constant cardiac output the power observed at low frequencies in the MAP spectrum represented 95.0 +/- 2.7% of the total power compared with 75.5 +/- 4.6% during normal variations in heart rate and cardiac output (P < 0.05). In addition, when cardiac output was held constant, the power observed at higher frequencies markedly decreased from 24.5 +/- 4.6% of total power during AV-linked stimulation to only 5.0 +/- 2.7% of total power during constant cardiac output (P < 0.05). We conclude that low-frequency oscillations in MAP are due to changes in peripheral resistance, whereas a significant amount of high-frequency changes in MAP stems from spontaneous changes in cardiac output.

scholarly journals External validity of a model to predict postoperative atrial fibrillation after thoracic surgery

2019 ◽  
Vol 57 (5) ◽  
pp. 874-880 ◽  
Author(s):  
Heather Smith ◽  
Heidi Li ◽  
Olivier Brandts-Longtin ◽  
Ching Yeung ◽  
Donna Maziak ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Thoracic Surgery ◽  
Risk Score ◽  
External Validation ◽  
Postoperative Atrial Fibrillation ◽  
Risk Scores ◽  
Incidence Risk ◽  
Lung Resections ◽  
Mean Heart Rate

Abstract OBJECTIVES A prediction model developed by Passman et al. stratifies patients’ risk of postoperative atrial fibrillation (POAF) after major non-cardiac thoracic surgery using 3 simple factors (sex, age and preoperative resting heart rate). The model has neither undergone external validation nor proven to be relevant in current thoracic surgery practice. METHODS A retrospective single-centre analysis of all patients who underwent major non-cardiac thoracic surgery (2008–2017) with prospective documentation of incidence and severity of POAF was used for external validation of Passman’s derivation sample (published in 2005 with 856 patients). The model calibration was assessed by evaluating the incidence of POAF and patients’ risk scores (0–6). RESULTS A total of 2054 patients were included. Among them, POAF occurred in 164 (7.9%), compared to 147 (17.2%) in Passman’s study. Differences in our sample compared to Passman’s sample included mean heart rate (75.7 vs 73.7 bpm, P &lt; 0.001), proportion of patients with hypertension (46.1 vs 29.4%, P &lt; 0.001), proportion of extensive lung resections, particularly pneumonectomy (6.1 vs 21%, P &lt; 0.001) and proportion of minimally invasive surgeries (56.6% vs 0%). The model demonstrated a positive correlation between risk scores and POAF incidence (risk score 1.2% vs 6.16%). CONCLUSIONS The POAF model demonstrated good calibration in our population, despite a lower overall incidence of POAF compared to the derivation study. POAF rates were higher among patients with a higher risk score and undergoing procedures with greater intrathoracic dissection. This tool may be useful in identifying patients who are at risk of POAF when undergoing major thoracic surgery and may, therefore, benefit from targeted prophylactic therapy.

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