Mathew et al developed a risk index for predicting recurrence of atrial fibrillation following surgery. This can help identify patients who may require more aggressive monitoring and therapy. The authors are from the Investigators of the Ischemia Research and Education Foundation and the Multicenter Study of Perioperative Ischemia Research Group.
Parameters:
(1) age of the patient in years
(2) history of congestive heart failure
(3) left ventricular hypertrophy
(4) aortic atherosclerosis
(5) bicaval cannulation during surgery
(6) withdrawal of ACE inhibitors for surgery
(7) withdrawal of beta-blocker therapy for surgery
(8) postoperative therapy with amiodarone
(9) postoperative therapy with digoxin
|
Parameter |
Finding |
Points |
|
age of the patient |
< 40 years |
2 |
|
|
40 – 49 years |
4 |
|
|
50 – 59 years |
6 |
|
|
60 – 69 years |
8 |
|
|
70 – 79 years |
10 |
|
|
>= 80 years |
12 |
|
history of congestive heart failure |
no |
0 |
|
|
yes |
-4 |
|
left ventricular hypertrophy |
no |
0 |
|
|
yes |
5 |
|
aortic atherosclerosis |
none |
0 |
|
|
mild |
0 |
|
|
moderate |
5 |
|
|
severe |
5 |
|
bicaval cannulation |
no |
0 |
|
|
yes |
4 |
|
withdrawal of ACE inhibitors |
no |
0 |
|
|
yes |
6 |
|
withdrawal of beta-blocker therapy |
no |
0 |
|
|
yes |
7 |
|
postoperative therapy with amiodarone |
no |
0 |
|
|
yes |
-7 |
|
postoperative therapy with digoxin |
no |
0 |
|
|
yes |
-6 |
total index =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -15
• maximum score: 39
• The higher the score the greater the risk for recurrence of atrial fibrillation.
|
Index |
Risk |
|
<= 9 |
low |
|
10 – 22 |
medium |
|
> 22 |
high |
Specialty: Anesthesiology, Cardiology
