Evidence map›Paper›PMID 41964448›Full record

ArticleEuropean heart journal2026

New-onset postoperative atrial fibrillation management and outcomes: the VISION Cardiac Surgery cohort.

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 and 16 more

Abstract readMulticenter Study
In one paragraph

Article in European heart journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

William F McIntyrePopulation Health Research Institute, 237 Barton St E, L8L 2X2, Hamilton, Ontario, Canada.ORCID 0000-0001-6082-7542
P J DevereauxPopulation Health Research Institute, 237 Barton St E, L8L 2X2, Hamilton, Ontario, Canada.ORCID 0000-0003-2935-637X
Emilie P Belley-CotePopulation Health Research Institute, 237 Barton St E, L8L 2X2, Hamilton, Ontario, Canada.ORCID 0000-0002-5071-076X
Jessica D SpencePopulation Health Research Institute, 237 Barton St E, L8L 2X2, Hamilton, Ontario, Canada.ORCID 0000-0003-1267-9455
Robin ZhaoPopulation Health Research Institute, 237 Barton St E, L8L 2X2, Hamilton, Ontario, Canada.
Matthew T V ChanThe Chinese University of Hong Kong, Room G07, G/F, Choh-Ming Li Basic Medical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.
Vladimir V LomivorotovNovosibirsk State University, 52 Krasnyy Ave, 630091, Novosibirsk, Russia.
Giovanni LandoniDepartment of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute,Via Olgettina 58, 20132 Milan, Italy.ORCID 0000-0002-8594-5980
Domenico PaparellaDepartment of Medical and Surgical Sciences, University of Foggia, Viale Luigi Pinto, 171122 Foggia, Italy.
Graham S HillisDepartment of Cardiology, Royal Perth Hospital and School of Medicine, University of Western Australia, 197 Wellington Street, Perth WA 6000, Australia.ORCID 0000-0003-2417-4673
Nicholas L MillsUsher Institute of Population Health Sciences and Informatics, University of Edinburgh, 5-7 Little France Road Edinburgh BioQuarter - Gate 3, Edinburgh, EH16 4UX, UK.
Joel ParlowDepartment of Anesthesiology and Perioperative Medicine, Queen's University, 76 Stuart Street, Kingston, Ontario K7L 2V7, Canada.
Katheryn BradyPopulation Health Research Institute, 237 Barton St E, L8L 2X2, Hamilton, Ontario, Canada.
S Ming ChenDepartment of Medicine, McMaster University, 1280 Main St W, 48S 4L8, Hamilton, Ontario, Canada.
Leah HaywardHamilton Health Sciences, 237 Barton St East, L8L 2X2, Hamilton, Ontario, Canada.
Clara HealeyTemerty Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, Ontario M5S 3K3, Canada.
Amna IsmailiDepartment of Medicine, McMaster University, 1280 Main St W, 48S 4L8, Hamilton, Ontario, Canada.
Ryan LouiePopulation Health Research Institute, 237 Barton St E, L8L 2X2, Hamilton, Ontario, Canada.
Charlotte McEwenDepartment of Medicine, McMaster University, 1280 Main St W, 48S 4L8, Hamilton, Ontario, Canada.ORCID 0000-0002-2336-3491
Courtney MullenHamilton Health Sciences, 237 Barton St East, L8L 2X2, Hamilton, Ontario, Canada.
Maia ShenDepartment of Medicine, McMaster University, 1280 Main St W, 48S 4L8, Hamilton, Ontario, Canada.
Charlotte TanDepartment of Medicine, McMaster University, 1280 Main St W, 48S 4L8, Hamilton, Ontario, Canada.
Sandra OforiPopulation Health Research Institute, 237 Barton St E, L8L 2X2, Hamilton, Ontario, Canada.ORCID 0000-0002-1691-0979
Jeff S HealeyPopulation Health Research Institute, 237 Barton St E, L8L 2X2, Hamilton, Ontario, Canada.ORCID 0000-0003-1216-7580
Andre LamyPopulation Health Research Institute, 237 Barton St E, L8L 2X2, Hamilton, Ontario, Canada.
Richard P WhitlockPopulation Health Research Institute, 237 Barton St E, L8L 2X2, Hamilton, Ontario, Canada.ORCID 0000-0002-6863-5884

Funding

Academic Health Science Centres Alternative Funding Plan Innovation Fund OntarioBritish Heart Foundation Personal Chair CH/F/21/90010Canadian Institutes of Health Research FoundationCanadian Institutes of Health Research Strategy for Patient Oriented ResearchCanadian Network and Centre for Trials InternationallyCIHRGeneral Research Fund 14101414Hamilton Health Sciences New Investigator FundHamilton Health Sciences Research Strategic InitiativeHong Kong Special Administrative RegionInstituto de Salud Carlos III PI13/00502McMaster University Surgical AssociatesNational Health and Medical Research ProgramNational Heart Foundation of Australia Vanguard Grant 101034Population Health Research Institute Internal Funding ProgramResearch Excellence RE/18/5/34216Research Grant CouncilUniversity of Malaya RG302-14AFR
6 · The paper itself

Abstract

BACKGROUND AND

aimsNew-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.

methodsVISION 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.

resultsAmong 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).

conclusionsNew-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.

Indexed as

Atrial FibrillationCardiac Surgical ProceduresPostoperative ComplicationsAgedAnti-Arrhythmia AgentsAnticoagulantsFemaleHumansIncidenceMaleMiddle AgedPlatelet Aggregation InhibitorsProspective StudiesTreatment OutcomeAnti-Arrhythmia AgentsAnticoagulantsPlatelet Aggregation InhibitorsCardiac SurgeryEpidemiologyPOAFPost-operative atrial fibrillation

Identifiers

PMID41964448
PMCPMC13268691

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.