OBJECTIVES Cardiopulmonary bypass (CPB) management may potentially play a role in the development of new-onset atrial fibrillation (AF) after cardiac surgery. The aim of this study was to explore this potential association. METHODS Patients who underwent coronary artery bypass grafting and/or valvular surgery during 2016-2020 were included in an observational single-centre study. Data collected from the Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies registry and a local CPB database were merged. Associations between individual CPB variables (CPB and aortic clamp times, arterial and central venous pressure, mixed venous oxygen saturation, blood flow index, bladder temperature and haematocrit) and new-onset AF were analysed using multivariable logistic regression models adjusted for patient characteristics, comorbidities and surgical procedure. RESULTS Out of 1999 patients, 758 (37.9%) developed new-onset AF. Patients with new-onset postoperative AF were older, had a higher incidence of previous stroke, worse renal function and higher EuroSCORE II and CHA2DS2-VASc scores and more often underwent valve surgery. Longer CPB time [adjusted odds ratio 1.05 per 10 min (95% confidence interval 1.01-1.08); P = 0.008] and higher flow index [adjusted odds ratio 1.21 per 0.2 l/m2 (95% confidence interval 1.02-1.42); P = 0.026] were associated with an increased risk for new-onset AF, while the other variables were not. A sensitivity analysis only including patients with isolated coronary artery bypass grafting supported the primary analyses. CONCLUSIONS CPB management following current guideline recommendations appears to have minor or no influence on the risk of developing new-onset AF after cardiac surgery.

中文翻译：

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心肺绕道管理和心脏手术后新发心房颤动的风险。

目的 体外循环（CPB）管理可能在心脏手术后新发心房颤动（AF）的发生中发挥作用。本研究的目的是探索这种潜在的关联。方法 2016 年至 2020 年期间接受冠状动脉旁路移植术和/或瓣膜手术的患者被纳入一项观察性单中心研究。从瑞典网络系统收集的数据被合并，该系统用于根据推荐疗法评估的心脏病循证护理的增强和发展登记和当地的CPB数据库。使用根据患者特征、合并症进行调整的多变量逻辑回归模型，分析个体 CPB 变量（CPB 和主动脉钳夹时间、动脉和中心静脉压、混合静脉氧饱和度、血流指数、膀胱温度和血细胞比容）与新发 AF 之间的关联和手术程序。结果 1999 名患者中，758 名 (37.9%) 出现新发 AF。术后新发 AF 患者年龄较大，既往卒中发生率较高，肾功能较差，EuroSCORE II 和 CHA2DS2-VASc 评分较高，且更常接受瓣膜手术。较长的 CPB 时间[调整后的比值比为每 10 分钟 1.05（95% 置信区间 1.01-1.08）；P = 0.008]和更高的流量指数[调整后的优势比为每 0.2 l/m2 1.21（95% 置信区间 1.02-1.42）；P = 0.026] 与新发 AF 风险增加相关，而其他变量则不然。仅包括接受离体冠状动脉旁路移植术的患者的敏感性分析支持了主要分析。结论 遵循当前指南建议的 CPB 管理似乎对心脏手术后发生新发 AF 的风险影响很小或没有影响。