Skip to main content

Atrial fibrillation following major noncardiac thoracic surgery: significance and impact on morbidity


Atrial fibrillation (AF) is a common complication after noncardiac thoracic surgery. Its impact on overall mortality has not yet been fully assessed and few data are available on the effects of the noncardiac post-thoracotomy AF on clinical outcomes.


From July 2006 to July 2011, 226 consecutive patients undergoing lung resection for lung cancer were studied retrospectively. Preoperative data and serial electrocardiograms were evaluated. Hypertension, dyslipidaemia, diabetes mellitus, smoking and advanced age (>75 years) were considered as risk factors. Patients (n = 97) who had structural heart disease or ≥2 risk factors were considered a high-risk group whereas those with <2 risk factors constituted the low-risk group.


Thirty-two patients (14.16%) experienced new-onset post-operative AF. The high-risk group had a 58% incidence of AF compared with 23% in the low-risk group (P < 0.001). Moreover, following β-blocker administration, more of the high-risk group required antiarrhythmic treatment with amiodarone than did the low-risk group (67% vs. 35% respectively, P = 0.02). Patients who developed AF had a significantly longer hospital stay (P < 0.01). The 30-day mortality rate was significantly higher in the high-risk group (11% vs. 2%; P = 0.03) but AF was not an independent risk factor for death. In the multivariate analysis, major resection (pneumonectomy) and advanced age were identified as independent risk factors for the development of postoperative AF (P = 0.004 and P = 0.008 respectively).


Atrial fibrillation occurrence after lung resection does not independently affect the short-term mortality but is associated with a prolonged length of hospital stay.

Author information

Authors and Affiliations


Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Michalopoulou, H., Stamatis, P., Michaloliakou, M. et al. Atrial fibrillation following major noncardiac thoracic surgery: significance and impact on morbidity. Crit Care 16, P473 (2012).

Download citation

  • Published:

  • DOI:


  • Atrial Fibrillation
  • Independent Risk Factor
  • Amiodarone
  • Lung Resection
  • Longe Hospital Stay