Atrial fibrillation is a common complication of cardiac surgery, occurring in 10 percent to 40 percent of patients. Recent studies show it to be associated with poorer health following surgery and poorer long-term survival. Furthermore, development of atrial fibrillation after cardiac surgery leads to average additional health care costs of $15,000 to $20,000.
As part of an ongoing NIH National Heart Lung and Blood Institute study, Giovanni Filardo, PhD, MPH, and his team are executing a large national multicenter study assessing the effectiveness of optimal preventive and management strategies (based on AHA/ACC/ESC and AACP guidelines) and their impact on incidence of post- coronary artery bypass graft surgery (CABG) atrial fibrillation and long-term survival. Dr. Filardo is Director of epidemiology, Baylor Health Care System's Institute for Health Care Research and Improvement and The Bradley Family Endowed Chair in Cardiovascular Epidemiology, Baylor University Medical Center.
"Currently, we do not know what causes post-operative atrial fibrillation, nor how to identify patients at high risk and effectively prevent or mitigate this complication," explains Dr. Filardo. "These are the questions that the study seeks to answer."
Investigators will look at patients who underwent isolated coronary artery bypass graft surgery at Baylor University Medical Center (Dallas, TX) (BIUMC), THE HEART HOSPITAL Baylor Plano (Plano, TX) (THHBP), Emory University (Atlanta, GA), University of Virginia (Charlottesville, VA) or Washington University (St. Louis, MO). The study will provide insights into the prevention and management of post-operative atrial fibrillation, allowing health care providers to improve survival and decrease costs of care associated with coronary artery bypass graft surgery.
The potential public health impact and cost savings are enormous: more than 100,000 people in the United States and 1.5 million people worldwide undergo isolated coronary artery bypass graft surgery each year. "Even taking the conservative estimate of 20 percent of those patients developing atrial fibrillation, the results of this study stand to improve survival for 300,000 people and save as much as $6 billion (300,000 people x $20,000 cost attributable to post-operative atrial fibrillation) in health care costs each year," said Dr. Filardo.