Chronic Preoperative B-blocker Therapy and Postoperative Atrial Fibrillation after Elective Ascending Aortic Surgery

Postoperative atrial fibrillation (POAF) is a frequent complication following cardiac surgery and is associated with increased morbidity and mortality. Although b-blockers are commonly used for POAF prevention, their efficacy in patients undergoing elective surgery of the ascending aorta remains unclear.

We aimed to evaluate the impact of chronic preoperative b-blocker therapy on the occurrence of POAF in patients undergoing elective ascending thoracic aortic surgery.

This single-center, retrospective observational study included adult patients who underwent elective surgical aneurysm repair of the ascending aorta between 2012 and 2021.

Patients with a documented history of paroxysmal, persistent, or permanent atrial fibrillation were excluded. Acute aortic dissection cases were also excluded.

Associations between preoperative b-blockers therapy and POAF, as well as postoperative clinical outcomes, were assessed using Chi-square tests and independent-samples t -tests.

A total of 214 patients were included in the analysis. POAF occurred in 46% of patients. Chronic preoperative b-blocker therapy was not significantly associated with the development of POAF ( P = 0.058). Among postoperative outcomes, stroke was significantly more frequent in patients who developed POAF ( P = 0.026), whereas no significant associations were observed with acute kidney injury, renal replacement therapy, reintubation, or in-hospital mortality.

In patients undergoing elective ascending aortic surgery, chronic preoperative b-blocker therapy was not significantly associated with a reduced incidence of POAF. These findings suggest that POAF risk in aortic surgery may be influenced by factors beyond conventional pharmacological prophylaxis.