ArticleDiseases of the esophagus : official journal of the International Society for Diseases of the Esophagus2026
Impact of new-onset atrial fibrillation on 12-month outcomes and mortality after esophagectomy.
Article in Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
New-onset atrial fibrillation (NOAF) is a frequent complication after esophagectomy. While associated with adverse short-term outcomes, its longer-term cardiovascular impact remains uncertain. We evaluated associations between NOAF and postoperative cardiovascular and respiratory complications using a large international real-world dataset. We performed a retrospective cohort study using the TriNetX global federated health research network. Adults undergoing esophagectomy were identified using ICD-10, CPT, and SNOMED codes, excluding those with prior atrial fibrillation or flutter. NOAF was defined within 30 days postoperatively. Propensity score matching (1:1) balanced demographics, comorbidities, and medication use. Outcomes were assessed over 12 months using Cox proportional hazards models. We analyzed 1977 matched patients (mean age 67.1 ± 8.7 years; 18% female). Within 0-3 months, NOAF was associated with increased risks of death (HR 2.09, 95% CI 1.62-2.70), heart failure (HR 2.03, 95% CI 1.32-3.11), myocardial infarction (HR 2.35, 95% CI 1.17-4.74), pneumonia (HR 1.80, 95% CI 1.42-2.29), venous thromboembolism (HR 1.76, 95% CI 1.17-2.66), and rehospitalization (HR 2.78, 95% CI 2.42-3.20), with no significant association for stroke. Between 3 and 12 months, elevated risks persisted for death (HR 1.60, 95% CI 1.30-1.98) and heart failure (HR 2.55, 95% CI 1.37-4.73). Across 12 months, NOAF remained associated with death (HR 1.76, 95% CI 1.50-2.07) and heart failure (HR 2.23, 95% CI 1.56-3.19). NOAF after esophagectomy identifies patients at increased risk of major postoperative and cardiovascular complications, particularly early after surgery.
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