September 10, 2012 — Atrial fibrillation (AF) is a common complication of cardiac surgery, occurring in 10 to 40 percent of patients. Recent studies show it to be associated with poorer health following surgery and poorer long-term survival. Furthermore, development of AF after cardiac surgery leads to average additional healthcare costs of $15,000 to $20,000.
As part of an ongoing NIH National Heart Lung and Blood Institute study, Giovanni Filardo, Ph.D., MPH, and his team are executing a large national multicenter study assessing the effectiveness of optimal preventive and management strategies (based on American Heart Association/American College of Cardiology/European Society of Cardiology [AHA/ACC/ESC] and AACP guidelines) and their impact on the incidence of post-CABG (coronary artery bypass graft surgery) AF and long-term survival. Filardo is director of epidemiology at Baylor Health Care System’s Institute for Health Care Research and Improvement, and The Bradley Family Endowed Chair in cardiovascular epidemiology at Baylor University Medical Center.
"Currently we do not know what causes post-operative AF, nor how to identify patients at high risk and effectively prevent or mitigate this complication," said Filardo. "These are the questions that the study seeks to answer."
The retrospective study will look at patients who underwent isolated CABG surgery at Baylor University Medical Center (Dallas), Baylor Heart Hospital (Plano, Texas), Emory University (Atlanta), University of Virginia (Charlottesville, Va.) or Washington University (St. Louis). The study will provide insights into the prevention and management of post-operative AF, allowing healthcare providers to improve survival and decrease costs of care associated with CABG surgery.
More than 100,000 people in the United States and 1.5 million people worldwide undergo isolated CABG surgery each year. "Even taking the conservative estimate of 20 percent of those patients developing AF, the results of this study stand to improve survival for 300,000 people and save as much as $6 billion ($20,000 per person cost attributable to post-operative AF) in healthcare costs each year," said Filardo.
The purpose of the study is to identify the causes of new-onset AF in patients undergoing cardiac surgery, and whether current guidelines for high-risk patients are effective in preventing new-onset AF or if treatment protocols for those patients who do experience the condition are effective in improving survival. The study will be completed in April 2014.
For more information: www.baylorhealth.edu/research