• Kiramat Ullah Khan, Tahir Iqbal, Arooba Tariq, Mubeen Ali, and Niaz Ali.
• Department of Cardiac Surgery, Northwest General Hospital and Research Centre, Peshawar, Pakistan.
• J Coll Physicians Surg Pak. 2024 Oct 1; 34 (10): 123312371233-1237.

ObjectiveTo determine the frequency and outcome of postoperative atrial fibrillation (POAF) in terms of in-hospital and 30-day mortality and morbidity after mitral valve replacement (MVR).Study DesignObservational study. Place and Duration of the Study: Department of Cardiac Surgery, Northwest General Hospital and Research Centre, Peshawar, Pakistan, from September 2017 to March 2023.MethodologyA total of 186 patients between the ages of 20 and 70 years, who had severe mitral stenosis and normal sinus rhythm and underwent MVR surgery, were included in the study. The frequency of POAF within 7 days following surgery and outcomes in terms of in-hospital and 30-day mortality / morbidity were recorded.ResultsPOAF occurred in 19.4% patients. Patients with POAF were predominantly male (p = 0.01), aged over 50 years (p = 0.002), diabetic (p = 0.02), hypertensive (p = 0.02), had impaired LV function (p <0.001), enlarged LA (p = 0.003), pulmonary hypertension (p = 0.009), previous PMBV (p <0.001), and previous infective endocarditis (p <0.001). In-hospital and 30-day mortality rates were 7% and 8.6%, respectively. POAF patients had prolonged ICU stays (p <0.001), hospital stays (p = 0.04), and higher mortality rates (p <0.001). Persistent AF (22%) contributed to 30-day morbidity in the form of embolic stroke, limb ischaemia, and congestive heart failure.ConclusionPOAF commonly occurs following the MVR surgery and significantly impacts perioperative and 30-day morbidity and mortality.Key WordsPostoperative atrial fibrillation, Mitral stenosis, Mitral valve replacement.

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