Email updates

Keep up to date with the latest news and content from Journal of Cardiothoracic Surgery and BioMed Central.

Open Access Highly Accessed Research article

Atrial fibrillation after pulmonary lobectomy for lung cancer affects long-term survival in a prospective single-center study

Andrea Imperatori1*, Giovanni Mariscalco2, Giuditta Riganti1, Nicola Rotolo1, Valentina Conti1 and Lorenzo Dominioni1

Author Affiliations

1 Department of Surgical and Morphological Sciences, Center for Thoracic Surgery, Varese University Hospital, University of Insubria, Varese, Italy

2 Department of Surgical and Morphological Sciences, Cardiac Surgery Unit, Varese University Hospital, University of Insubria, Varese, Italy

For all author emails, please log on.

Journal of Cardiothoracic Surgery 2012, 7:4  doi:10.1186/1749-8090-7-4

Published: 10 January 2012



Atrial fibrillation (AF) after thoracic surgery is a continuing source of morbidity and mortality. The effect of postoperative AF on long-term survival however has not been studied. Our aim was to evaluate the impact of AF on early outcome and on survival > 5 years after pulmonary lobectomy for lung cancer.


From 1996 to June 2009, 454 consecutive patients undergoing lobectomy for lung cancer were enrolled and followed-up until death or study end (October 2010). Patients with postoperative AF were identified; AF was investigated with reference to its predictors and to short- and long-term survival (> 5 years).


Hospital mortality accounted for 7 patients (1.5%), while postoperative AF occurred in 45 (9.9%). Independent AF predictors were: preoperative paroxysmal AF (odds ratio [OR] 5.91; 95%CI 2.07 to 16.88), postoperative blood transfusion (OR 3.61; 95%CI 1.67 to 7.82) and postoperative fibro-bronchoscopy (OR 3.39; 95%CI 1.48 to 7.79). Patients with AF experienced higher hospital mortality (6.7% vs. 1.0%, p = 0.024), longer hospitalization (15.3 ± 10.1 vs. 12.2 ± 5.2 days, p = 0.001) and higher intensive care unit admission rate (13.3% vs. 3.9%, p = 0.015). The median follow-up was 36 months (maximum: 179 months). Among the 445 discharged subjects with complete follow-up, postoperative AF was not an independent predictor of mortality; however, among the 151 5-year survivors, postoperative AF independently predicted poorer long-term survival (HR 3.75; 95%CI 1.44 to 9.08).


AF after pulmonary lobectomy for lung cancer, in addition to causing higher hospital morbidity and mortality, predicts poorer long-term outcome in 5-year survivors.

Pulmonary lobectomy; Lung cancer; Atrial fibrillation; Arrhythmia; Prognosis; Mortality