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    "description": "Abstract\nPurposeLate-onset atrial fibrillation (LOAF) after valve surgery for degenerative mitral valve disease often with underlying mitral valve prolapse is a known phenomenon. However, there is no similar data for postoperative rheumatic heart disease (RHD) patients. We sought to assess the incidence and predictors of LOAF during postoperative follow-up in RHD patients.MethodsThis single-center retrospective case\u2013control study included a total of 384 RHD patients with normal sinus rhythm (NSR) who underwent rheumatic valve surgery between 1st July 2008 and 30th June 2013. Patients detected with de novo persistent atrial fibrillation (AF) after 2\u00a0months of valve surgery were diagnosed as having LOAF. Presurgical demographic and echocardiographic parameters were compared between the LOAF and NSR groups to identify risk factors for LOAF.ResultsThe incidence of de novo LOAF after rheumatic valve surgery was 9.63% at an average of 2.67\u2009\u00b1\u20091.32\u00a0years follow-up. Age\u2009\u2265\u200932\u00a0years [OR 2.4 (95% CI 1.2\u20135.1); P\u2009=\u20090.01] and left atrial (LA) size\u2009\u2265\u200951\u00a0mm [OR 5.9 (95% CI 2.8\u201312.4); P\u2009<\u20090.0001] were the most significant and independent predictors of LOAF. Moreover, significant mitral valve disease was associated with a higher risk of LOAF than significant aortic valve disease (P\u2009=\u20090.037). LA size\u2009\u2265\u200951\u00a0mm at surgery showed a fair discriminative power [AUC\u2009=\u20090.75; sensitivity\u2009=\u200968%, specificity\u2009=\u200970%] to identify patients at high risk for LOAF.ConclusionsLate-onset AF develops in almost a tenth of the RHD patients postoperatively following corrective valve surgery. Preoperative LA size can be used to identify patients at high risk for LOAF.", 
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        "publisher": "Springer Nature", 
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    "keywords": [
      "rheumatic heart disease patients", 
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      "persistent atrial fibrillation", 
      "mitral valve disease", 
      "atrial fibrillation", 
      "heart disease patients", 
      "normal sinus rhythm", 
      "valve disease", 
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      "LA size", 
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      "single-center retrospective case-control study", 
      "significant mitral valve disease", 
      "significant aortic valve disease", 
      "retrospective case-control study", 
      "degenerative mitral valve disease", 
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      "corrective valve surgery", 
      "preoperative LA size", 
      "aortic valve disease", 
      "mitral valve prolapse", 
      "case-control study", 
      "echocardiographic parameters", 
      "atrial size", 
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      "risk factors", 
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      "incidence", 
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      "risk", 
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    "name": "Incidence and predictors of de novo late-onset persistent atrial fibrillation in postoperative rheumatic heart disease patients (LOAF-RHD study)", 
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