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Risk Factors for Chronic Atrial Fibrillation Development After Esophagectomy for Esophageal Cancer

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

This study investigates the prognosis of patients with postoperative atrial fibrillation (POAF), aiming to elucidate predictors of occurrence of atrial fibrillation (AF) in the chronic phase after esophagectomy.

Methods

We retrospectively analyzed 415 consecutive patients between July 2010 and December 2021 who were scheduled to undergo esophagectomy for esophageal cancer and had no previous history of AF.

Results

POAF occurred in 73 patients (18%). Their ages were higher than those without POAF (72 [66–77] vs 68 [62–75], P < 0.01). Three-field lymph node dissection was more frequent in patients with POAF (63% vs 50%, P = 0.04). Overall survival rates were not significantly different between those with and without POAF in patients with stage III/IV cancer (P = 0.37), but overall survival rate of patients with POAF was lower than in those without POAF in stage I/II cancer (P = 0.03). Seventeen patients (4.1%) had recurrence of AF or new onset 31 days after esophagectomy. POAF was the only independent predictor of AF development in the chronic phase (HR: 4.09, 95%CI: [1.42–11.74], P = 0.01). AF development in the chronic phase was observed in 8 patients (11.0%) with and 9 patients (2.6%) without POAF (P < 0.01). AF development rates were not significantly different in patients with stage III/IV cancer (P = 0.05), but there was significant difference in patients with stage I/II cancer (P < 0.01).

Conclusion

The occurrence of POAF after esophagectomy is related with future development of AF and overall survival prognosis. Future studies must ascertain optimal therapeutic strategy.

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Acknowledgements

We acknowledge proofreading and editing by Benjamin Phillis at the Clinical Study Support Center at Wakayama Medical University.

Funding

This work was supported in part by JSPS KAKENHI Grant Numbers 18 K15858 and 20 K08406.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan

    Manabu Kashiwagi, Akio Kuroi, Kosei Terada, Takashi Tanimoto & Atsushi Tanaka

  2. Second Department of Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan

    Toshiyasu Ojima, Keiji Hayata, Junya Kitadani, Akihiro Takeuchi & Hiroki Yamaue

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  1. Manabu Kashiwagi
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  2. Toshiyasu Ojima
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  3. Keiji Hayata
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  5. Akihiro Takeuchi
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Correspondence to Toshiyasu Ojima.

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Kashiwagi, M., Ojima, T., Hayata, K. et al. Risk Factors for Chronic Atrial Fibrillation Development After Esophagectomy for Esophageal Cancer. J Gastrointest Surg 26, 2451–2459 (2022). https://doi.org/10.1007/s11605-022-05493-9

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