{"id":"46032","type":"article","url":"https://hartvaat.nl/2026/04/08/vision-postoperatief-atriumfibrilleren-na-hartchirurgie-verhoogt-sterfte-na-een-/","title":"VISION: postoperatief atriumfibrilleren na hartchirurgie verhoogt sterfte na een jaar","title_en":"New-onset postoperative atrial fibrillation management and outcomes: the VISION Cardiac Surgery cohort.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"European heart journal","doi":"10.1093/eurheartj/ehag236","source_url":"https://doi.org/10.1093/eurheartj/ehag236","authors":["William F McIntyre","P J Devereaux","Emilie P Belley-Cote","Jessica D Spence","Robin Zhao","Matthew T V Chan","Vladimir V Lomivorotov","Giovanni Landoni","Domenico Paparella","Graham S Hillis","Nicholas L Mills","Joel Parlow","Katheryn Brady","S Ming Chen","Leah Hayward","Clara Healey","Amna Ismaili","Ryan Louie","Charlotte McEwen","Courtney Mullen","Maia Shen","Charlotte Tan","Sandra Ofori","Jeff S Healey","Andre Lamy","Richard P Whitlock"],"significance":7,"published":"2026-07-15","source_date":"2026-04-08","image":"","kennis":["https://hartvaat.nl/kennis/vasculair/antistolling-bij-vte/","https://hartvaat.nl/kennis/vasculair/vaatchirurgie-perioperatief-cardiologisch-beleid/"],"congress":"","summary_en":"In the prospective VISION Cardiac Surgery cohort (12,234 patients, 12 countries), new-onset postoperative atrial fibrillation (POAF) occurred in 31.8% within 30 days of cardiac surgery. Antithrombotic and antiarrhythmic management varied widely: 15.6% received anticoagulation alone, 54.3% antiplatelets alone, 24% both, and 49% amiodarone. At one year, clinical AF was detected in 6.9% of POAF patients versus 0.6% without (aHR 11.3), and all-cause mortality was higher (3.0% vs 1.7%; aHR 1.54). POAF after cardiac surgery is thus common and associated with both more AF and higher mortality in the first year.","created":"2026-07-03T20:27:08Z","updated":"2026-07-04T19:27:01Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In het prospectieve VISION Cardiac Surgery-cohort (12.234 patiënten, 12 landen) trad nieuw postoperatief atriumfibrilleren (POAF) op bij 31,8% binnen 30 dagen na hartchirurgie. De antitrombotische en antiaritmische behandeling varieerde sterk: 15,6% kreeg alleen antistolling, 54,3% alleen plaatjesremmers, 24% beide, en 49% amiodaron. Na één jaar was klinisch AF vastgesteld bij 6,9% van de POAF-patiënten versus 0,6% zonder POAF (aHR 11,3) en was de totale sterfte hoger (3,0% versus 1,7%; aHR 1,54). POAF na hartchirurgie is dus frequent en hangt samen met zowel meer AF als hogere sterfte in het eerste jaar.","abstract_original":"BACKGROUND AND AIMS: New-onset atrial fibrillation (AF) is the most common complication of cardiac surgery. We aimed to describe the incidence of postoperative AF (POAF), its management, and its relationship to long-term outcomes in a prospective multi-centre cohort, as our current understanding comes primarily from registries and single-centre studies. METHODS: VISION Cardiac Surgery was a prospective cohort of adults who underwent cardiac surgery in 12 countries. The association of POAF with outcomes occurring between 30 days and 1 year postoperatively was estimated using a multivariable Cox model adjusted for patient and operative characteristics and for antithrombotic therapies. RESULTS: Among 12 234 patients (55.3% isolated coronary artery bypass grafting), 31.8% had POAF within 30 days of surgery. The proportion of participants with POAF who received anticoagulation alone at hospital discharge was 15.6%, 54.3% received antiplatelets alone, 23.9% received anticoagulation and antiplatelets, and 6.3% received neither; 48.8% were receiving amiodarone. At 1 year, clinical AF was detected in 6.9% of patients with POAF compared to 0.6% in those without [adjusted hazard ratio (aHR), 11.30; 95% confidence interval (CI) 8.17-15.70]. The primary composite outcome of stroke or vascular death occurred in 2.3% of patients with POAF and 1.5% in those without POAF (aHR 1.32; 95% CI 0.99-1.77). Patients with POAF had a higher risk of all-cause death (3.0% vs 1.7%; aHR 1.54; 95% CI 1.18-2.00). CONCLUSIONS: New-onset POAF occurs in a third of patients after cardiac surgery; its antithrombotic and antiarrhythmic management varies. Patients with POAF have increased risks of both clinical AF and of all-cause death in the year following surgery."}