Atrial fibrillation: a rare but probable adverse effect of sildenafil

Knowledge of the cardiovascular effects of sildenafil is important for a number of reasons. The main risk factors for the erectile dysfunction (hypercholesterolemia, hypertension, diabetes, smoking) are the same as those for coronary artery disease. The reported cardiovascular side effects of sildenafil in normal healthy population are minor and mainly associated with vasodialation (i.e. headache, flushing and small decrease in systolic and diastolic blood pressure). Authors report the occurrence of atrial fibrillation after the use of sildenafil in a normal healthy individual. To the best of our knowledge, there are only few case reports in the literature showing occurrence of atrial fibrillation with use of sildenafil.

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Prevalence, Epidemiological Characteristics, and Pharmacotherapy of Coronary Artery Disease among Patients with Atrial Fibrillation: Data from Jo-Fib Study

Medicina ◽

10.3390/medicina57060605 ◽

2021 ◽

Vol 57 (6) ◽

pp. 605

Author(s):

Hanna K. Al-Makhamreh ◽

Mohammed Q. Al-Sabbagh ◽

Ala’ E. Shaban ◽

Abdelrahman F. Obiedat ◽

Ayman J. Hammoudeh

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Antiplatelet Agents ◽

Retrospective Case ◽

Increased Risk ◽

Artery Disease ◽

Epidemiological Characteristics ◽

Cad Risk

Background and Objectives: Patients with AF are at increased risk for Coronary Artery Disease (CAD) owing to their shared etiologies and risk factors. This study aimed to assess the prevalence, cardiovascular risk factors, and used medications of CAD in AF patients. Materials and Methods: This retrospective, case-control study utilized data from the Jordanian Atrial Fibrillation (Jo-Fib) registry. Investigators collected clinical features, history of co-existing comorbidities, CHA2DS2-VASc, and HAS BLED scores for all AF patients aged >18 visiting 19 hospitals and 30 outpatient cardiology clinics. A multivariable binary logistic regression was used to asses for factors associated with higher odds of having CAD. Results: Out of 2000 patients with AF, 227 (11.35%) had CAD. Compared to the rest of the sample, those with CAD had significantly higher prevalence of hypertension (82.38%; p < 0.01), hypercholesterolemia (66.52%, p < 0.01), diabetes (56.83%, p < 0.01), and smoking (18.06%, p = 0.04). Patients with AF and CAD had higher use of anticoagulants/antiplatelet agents combination (p < 0.01) compared to the rest of the sample. Females had lower CAD risk than males (OR = 0.35, 95% CI: 0.24–0.50). AF Patients with dyslipidemia (OR = 2.5, 95% CI: 1.8–3.4), smoking (OR = 1.7, 95% CI: 1.1–2.6), higher CHA2DS2-VASc score (OR = 1.5, 95% CI: 1.4–1.7), and asymptomatic AF (OR = 1.9, 95% CI: 1.3–2.6) had higher risk for CAD. Conclusions: Owing to the increased prevalence of CAD in patients with AF, better control of cardiac risk factors is recommended for this special group. Future studies should investigate such interesting relationships to stratify CAD risk in AF patients. We believe that this study adds valuable information regarding the prevalence, epidemiological characteristics, and pharmacotherapy of CAD in patients with AF.

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Abstract 47: Atrial Fibrillation is Associated With Increased Risk of Incident Venous Thromboembolism: The Atherosclerosis Risk in Communities Study

Circulation ◽

10.1161/circ.135.suppl_1.47 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Pamela L Lutsey ◽

Faye L Norby ◽

Alvaro Alonso ◽

Mary Cushman ◽

Lin Y Chen ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Venous Thromboembolism ◽

Incidence Rate ◽

Case Reports ◽

Time Dependent ◽

Atherosclerosis Risk In Communities ◽

Increased Risk ◽

Atherosclerosis Risk ◽

Shared Risk

Background: It is well-established that atrial fibrillation (AF) is associated with thrombus formation in the left atrium, which can lead to ischemic stroke. Case reports, autopsies, and transesophageal echo data have indicated that clot formation also occurs in the right atrium (i.e. right-side intracardiac thrombosis) of AF patients, which could lead to pulmonary embolism (PE). However, it is unclear whether this occurrence is common. Objective: Test the hypotheses that individuals with incident AF are at elevated risk of developing venous thromboembolism (VTE), and that the association will be stronger for those presenting with PE alone versus PE and deep vein thrombosis (DVT) or DVT alone. Methods: A total of 15,205 Atherosclerosis Risk in Communities (ARIC) study participants, aged 45-64 years, were followed from baseline (1987-1989) to 2011 for incidence of AF and VTE (median follow-up 19.8 years). Incident AF and VTE events were identified via active surveillance and defined by relevant hospital discharge ICD codes. VTE events were validated by medical record review. Multivariable-adjusted Cox proportional hazards regression models were used, with AF modeled as a time-dependent covariate. We also evaluated separately risk of PE without evidence of DVT, DVT without PE, and events presenting with both PE and DVT. Results: At baseline participants were on average 54 years old, 55% female and 26% black. In the absence of AF there were 678 VTE events, for an incidence rate of 2.6 per 1000 person-years. After an AF diagnosis there were 77 events, with an incidence rate of 7.1 per 1000 person-years. In multivariable-adjusted models, having AF (versus no AF) was associated with a greater risk of incident VTE; the HR (95% CI) was 2.10 (1.65-2.68) after adjustment for demographics, 1.82 (1.42-2.32) additionally accounting for numerous AF and VTE risk factors, and 1.97 (1.53-2.53) after further adjusting for time-dependent anticoagulant use. When we restricted to PE events without evidence of DVT there were 188 events in total, of which 19 occurred following a diagnosis of AF. The HR for AF (versus no AF) was 1.53 (0.92-2.56) in fully adjusted models. For DVT alone there were 384 events in total, of which 48 occurred after AF diagnosis; the HR for AF was 2.43 (1.77-3.33). Among the 116 events presenting with both DVT and PE, 10 occurred after AF diagnosis, and the HR for AF was 1.36 (0.67-2.75). Conclusions: Diagnosis with AF was associated with a nearly 2-fold increased risk of incident VTE. The association was not stronger when isolated to those with PE without DVT, suggesting that higher risk of VTE among AF patients may be due to either the coagulation abnormalities that accompany AF, or shared risk factors that were not fully accounted for in this analysis.

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Predictive potential assessment of preoperative risk factors for atrial fibrillation in patients with coronary artery disease after coronary artery bypass grafting

The Siberian Journal of Clinical and Experimental Medicine ◽

10.29001/2073-8552-2020-35-4-128-136 ◽

2020 ◽

Vol 35 (4) ◽

pp. 128-136

Author(s):

K. I. Shakhgeldyan ◽

V. Y. Rublev ◽

B. I. Geltser ◽

B. O. Shcheglov ◽

V. G. Shirobokov ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Artery Bypass ◽

Bypass Grafting ◽

Preoperative Risk ◽

Preoperative Risk Factors ◽

Artery Disease

Introduction. Postoperative atrial fibrillation (POAF) is one of the most common complications of coronary artery bypass grafting (CABG) and occurs in 25–65% of patients.Aim. The study aimed to assess the predictive potential of preoperative risk factors for POAF in patients with coronary artery disease (CAD) after CABG based on machine learning (ML) methods.Material and Methods. An observational retrospective study was carried out based on data from 866 electronic case histories of CAD patients with a median age of 63 years and a 95% confidence interval [63; 64], who underwent isolated CABG on cardiopulmonary bypass. Patients were assigned to two groups: group 1 comprised 147 (18%) patients with newly registered atrial fibrillation (AF) paroxysms; group 2 included 648 (81.3%) patients without cardiac arrhythmia. The preoperative clinical and functional status was assessed using 100 factors. We used statistical analysis methods (Chi-square, Fisher, Mann – Whitney, and univariate logistic regression (LR) tests) and ML tests (multivariate LR and stochastic gradient boosting (SGB)) for data processing and analysis. The models’ accuracy was assessed by three quality metrics: area under the ROC-curve (AUC), sensitivity, and specificity. The cross-validation procedure was performed at least 1000 times on randomly selected data.Results. The processing and analysis of preoperative patient status indicators using ML methods allowed to identify 10 predictors that were linearly and nonlinearly related to the development of POAF. The most significant predictors were the anteroposterior dimension of the left atrium, tricuspid valve insufficiency, ejection fraction <40%, duration of the P–R interval, and chronic heart failure of functional class III–IV. The accuracy of the best predictive multifactorial model of LR was 0.61 in AUC, 0.49 in specificity, and 0.72 in sensitivity. The values of similar quality metrics for the best model based on SGB were 0.64, 0.6, and 0.68, respectively.Conclusion. The use of SGB made it possible to verify the nonlinearly related predictors of POAF. The prospects for further research on this problem require the use of modern medical care methods that allow taking into account the individual characteristics of patients when developing predictive models.

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World Anti-Doping Agency (WADA) and International Olympic Committee (IOC) list of prohibited substances and methods and their cardiovascular effects

The ESC Textbook of Sports Cardiology ◽

10.1093/med/9780198779742.003.0047 ◽

2019 ◽

pp. 427-432 ◽

Cited By ~ 1

Author(s):

Josef Niebauer ◽

Carl Johan Sundberg

Keyword(s):

Side Effects ◽

Sports Medicine ◽

Anabolic Steroids ◽

Cardiovascular Effects ◽

Left Ventricular ◽

Cardiovascular Side Effects ◽

World Anti Doping Agency ◽

Artery Disease ◽

Androgenic Anabolic Steroids ◽

Sports Sciences

The abuse of doping substances is prevalent in sports and in society at large. Doping substances are also present in a substantial fraction of nutritional supplements. They can cause severe side effects. This chapter is focused on cardiovascular side effects. Androgenic anabolic steroids can induce left ventricular hypertrophy, heart fibrosis, and systolic and diastolic dysfunction, and has been associated with dyslipidaemia, endothelial dysfunction, and coronary artery disease. Beta-2 agonists can induce chronotropic and inotropic effects, QT prolongation, palpitations, arrhythmias and sudden cardiac death. Erythropoietin can induce hypertension and embolism. Use of banned substances and methods in sports, i.e. doping, is prohibited, unethical, and dangerous. Research efforts in sports sciences and sports medicine are needed to prevent and treat doping abuse and to help athletes be successful without the need for doping.

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Diet and Lifestyle Factors and Risk of Atherosclerotic Cardiovascular Disease—A Prospective Cohort Study

Nutrients ◽

10.3390/nu13113822 ◽

2021 ◽

Vol 13 (11) ◽

pp. 3822

Author(s):

Stefan Acosta ◽

Anna Johansson ◽

Isabel Drake

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Atrial Fibrillation ◽

Cardiovascular Disease ◽

Diet Quality ◽

Atherosclerotic Cardiovascular Disease ◽

Artery Disease ◽

Fish And Shellfish ◽

Diet And Lifestyle ◽

Diet Score

Atherosclerotic cardiovascular disease (ACVD) is the leading cause of death worldwide. This study aimed to investigate the association between diet and lifestyle factors, beyond traditional risk factors, and the risk of incident ACVD. The Malmö Diet and Cancer study included 30,446 middle-aged individuals. Baseline examinations including a dietary assessment, questionnaire and interviews, were performed between 1991–1996. After excluding individuals with prevalent cardiovascular disease and atrial fibrillation or flutter, 26,990 participants remained. In a previously developed diet quality index, adherence to recommended intake of saturated fat (SFA), polyunsaturated fat (PUFA), fish and shellfish, fiber, vegetables and fruit, and sucrose results in one point per dietary component, with a maximum diet score of six points. Diagnosis of incident ACVD was based on validated diagnoses of coronary artery disease, atherothrombotic ischemic stroke, carotid artery disease or peripheral artery disease. Multivariable Cox regression analysis adjusting for established risk factors was performed to assess hazard ratios (HR) with 95% confidence intervals (CI). After a median follow-up of 21.1 years, 5858 (21.7%) individuals diagnosed with ACVD unrelated to atrial fibrillation or flutter were identified. Higher diet score (HR 0.94/point increase; 95% CI 0.91–0.97; p < 0.001), intake of fish and shellfish (HR 0.95/standard deviation (SD) increment, 95% CI 0.93–0.98), fiber (HR 0.93/SD increment, 95% CI 0.89–0.98) and SFA (HR 0.96/SD increment, 95% CI 0.92–0.99) consumption were associated with decreased risk for incident ACVD. High leisure-time physical activity (HR 0.82, 95% CI 0.74–0.91) was associated with reduced risk and obesity (HR 1.17, 95% CI 1.08–1.27) with increased risk of incident ACVD. The present study strengthens current recommendations of improving diet quality and increasing physical activity in preventing ACVD.

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Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association

Circulation ◽

10.1161/cir.0000000000000973 ◽

2021 ◽

Author(s):

Tiffany M. Powell-Wiley ◽

Paul Poirier ◽

Lora E. Burke ◽

Jean-Pierre Després ◽

Penny Gordon-Larsen ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Atrial Fibrillation ◽

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Weight Loss ◽

Coronary Artery ◽

Disease Risk ◽

Artery Disease ◽

The Impact

The global obesity epidemic is well established, with increases in obesity prevalence for most countries since the 1980s. Obesity contributes directly to incident cardiovascular risk factors, including dyslipidemia, type 2 diabetes, hypertension, and sleep disorders. Obesity also leads to the development of cardiovascular disease and cardiovascular disease mortality independently of other cardiovascular risk factors. More recent data highlight abdominal obesity, as determined by waist circumference, as a cardiovascular disease risk marker that is independent of body mass index. There have also been significant advances in imaging modalities for characterizing body composition, including visceral adiposity. Studies that quantify fat depots, including ectopic fat, support excess visceral adiposity as an independent indicator of poor cardiovascular outcomes. Lifestyle modification and subsequent weight loss improve both metabolic syndrome and associated systemic inflammation and endothelial dysfunction. However, clinical trials of medical weight loss have not demonstrated a reduction in coronary artery disease rates. In contrast, prospective studies comparing patients undergoing bariatric surgery with nonsurgical patients with obesity have shown reduced coronary artery disease risk with surgery. In this statement, we summarize the impact of obesity on the diagnosis, clinical management, and outcomes of atherosclerotic cardiovascular disease, heart failure, and arrhythmias, especially sudden cardiac death and atrial fibrillation. In particular, we examine the influence of obesity on noninvasive and invasive diagnostic procedures for coronary artery disease. Moreover, we review the impact of obesity on cardiac function and outcomes related to heart failure with reduced and preserved ejection fraction. Finally, we describe the effects of lifestyle and surgical weight loss interventions on outcomes related to coronary artery disease, heart failure, and atrial fibrillation.

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Abstract 14539: Incidence, Risk Factors, Natural History, and Outcomes of Atrial Fibrillation in Patients With Graves’ Disease

Circulation ◽

10.1161/circ.142.suppl_3.14539 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Jwan A Naser ◽

Sorin Pislaru ◽

Marius N Stan ◽

Grace Lin

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Major Cardiovascular Events ◽

Multivariate Risk ◽

Incidence Risk ◽

History Of ◽

Independent Risk Factors ◽

Artery Disease ◽

Overt Hyperthyroidism

Background: Hyperthyroidism is associated with atrial fibrillation (AF) with a reported prevalence of 16-60%. However, risk factors for onset of AF with hyperthyroidism are not well defined. We sought to identify patients with hyperthyroidism most likely to develop AF. Methods: We reviewed the medical records of 1371 consecutive patients with GD evaluated at our clinic between 2009 and 2019. GD-related AF was defined as AF diagnosed up to 30 days before or at any time after Grave’s disease (GD). Spontaneous recovery was defined as sinus rhythm after attainment of euthyroidism without the need for pharmacologic or electrical cardioversion. Outcomes of major cardiovascular events, all-cause mortality, and cardiac hospitalizations were compared between cases and controls (GD without AF) matched 1:1 for age, gender, and history of coronary artery disease. Results: AF occurred in 140 patients with an incidence of 10.2%. Older age (RR 1.63 per 10 years, p <0.001), male gender (RR 2.06, p < 0.001), overt hyperthyroidism (RR 2.48, p = 0.002), COPD (RR 2.14, p =0.006), and higher BMI (RR 1.03 per unit, p=0.023) were independent risk factors for AF. Spontaneous AF recovery occurred in 44 of 128 (34.6%) patients with adequate follow up. The multivariate risk factor for failed recovery was the presence of heart failure (HF) (OR =3.52, p= 0.004). GD patients with AF had higher rates of cardiac hospitalizations (Figure) that persisted even after adjusting to HF presence (27.9% vs 2.9%, p < 0.001). Conclusion: Risk factors for AF in GD are similar to those in the general population, although overt hyperthyroidism conferred the highest risk. These data argue for careful monitoring of GD patients with multimorbidity who may be at high risk of developing AF.

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Wound myiasis in Western Europe: prevalence and risk factors in a changing climate scenario

European Surgery ◽

10.1007/s10353-021-00730-y ◽

2021 ◽

Author(s):

Erika Andreatta ◽

Luigi Bonavina

Keyword(s):

Risk Factors ◽

Literature Review ◽

Western Europe ◽

Single Case ◽

Case Reports ◽

Case Series ◽

Climate Scenario ◽

Cutaneous Myiasis ◽

Artery Disease ◽

Wound Myiasis

Summary Background Myiasis is an infestation of neglected open wounds by fly larvae. Global warming, related climate changes, and increased traveling in tropical countries may contribute to the worldwide diffusion of new fly species. Common risk factors for myiasis are advanced age, poor hygiene, malnourishment, social isolation, diabetes, cancer, and peripheral artery disease. The aim of this study was to review the characteristics of cases of myiasis reported in Europe. Methods A narrative review of cutaneous myiasis was performed using PubMed, EMBASE, Web of Science database, and the search terms “human,” “myiasis,” “cutaneous myiasis,” “maggot,” “Europe,” “wound,” with the combination of “AND” and “OR.” In addition, hospital charts were reviewed to add personal experience to the literature review. Results Overall, 52 articles, both single case reports and case series reporting cutaneous myiasis, were found in the medical literature of the past two decades. A total of 64 patients living in Europe were identified, of whom 36% had wound myiasis. In addition to the literature review, we report the case of a male patient who presented with myiasis within a deep scalp ulcer occurring after radiotherapy for basal cell carcinoma. Conclusion Myasis is rare and possibly under-reported in Europe. The epidemiology of this infestation may be changing in the future due to climate variability, a rise in travel to tropical areas, and the migration of fly species.

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Predictors and risk model for heart failure hospitalization in atrial fibrillation patients without pre-existing heart failure: the Fushimi AF Registry

European Heart Journal ◽

10.1093/eurheartj/ehab724.0476 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

Y Hamatani ◽

M Iguchi ◽

K Minami ◽

K Ishigami ◽

S Ikeda ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Atrial Fibrillation ◽

Coronary Artery Disease ◽

Heart Disease ◽

Coronary Artery ◽

Risk Model ◽

The Mean ◽

Artery Disease

Abstract Background Atrial fibrillation (AF) increases the risk of hospitalization for heart failure (HF), as well as that of thromboembolism. The strategy for prediction of thromboembolism has been well-established; however, little focus has been placed on the risk stratification for and prevention of HF hospitalization in AF patients. Purpose The aim of this study is to investigate the predictors and risk model of HF hospitalization in non-valvular AF patients without pre-existing HF. Methods The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. The inclusion criterion of the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time, and there are no exclusion criteria. We started to enroll patients from March 2011, and follow-up data were available for 4,472 patients by the end of October 2020. From the registry, we excluded patients without a pre-existing HF (defined as having one of the following; prior hospitalization for HF, New York Heart Association class ≥2, or left ventricular ejection fraction [LVEF] <40%), and those with valvular AF (mitral stenosis or prosthetic heart valve). Among 3,188 non-valvular AF patients without pre-existing HF, we explored the risk factors for the HF hospitalization during follow-up period. The risk model for predicting HF hospitalization was determined by the cumulative numbers of risk factors which were significant on multivariate analysis. Results The mean age was 72.4±10.8 years, 1197 were female and 1787 were paroxysmal AF. The mean CHADS2 and CHA2DS2-VASc scores were 1.7±1.2 and 2.9±1.6, respectively. During the median follow-up period of 5.1 years, HF hospitalization occurred in 285 (8.9%), corresponding to an annual incidence of 1.8 events per 100 person-years. In multivariable Cox regression analysis, advanced age (≥75 years), valvular heart disease, coronary artery disease, reduced LVEF (<60%), chronic obstructive pulmonary disease (COPD) and anemia were independently associated with the higher incidence of HF hospitalization (all P<0.001) (Picture 1). A risk model based on these 6 variables could stratify the incidence of HF hospitalization during follow-up period (log-rank; P<0.001) (Picture 2). Patients with ≥3 risk factors had an 11-fold higher incidence of HF hospitalization compared with those not having any of these risk factors (hazard ratio: 11.3, 95% confidence interval: 7.0–18.4; P<0.001). Conclusions Advanced age, coronary artery disease, valvular heart disease, reduced LVEF, COPD and anemia were independently associated with the risk of HF hospitalization in AF patients without pre-existing HF. There was good prediction for endpoint of HF hospitalization using these 6 variables, providing the opportunities for the implementation of strategies to reduce the incidence of HF among AF patients. FUNDunding Acknowledgement Type of funding sources: None.

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Abstract 16415: Racial Differences in Incidence of Atrial Fibrillation After Cryptogenic Stroke

Circulation ◽

10.1161/circ.142.suppl_3.16415 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

David B Laslett ◽

Abdullah Haddad ◽

Dianna Gaballa ◽

Hardik Mangrolia ◽

Olivia Follis ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Racial Differences ◽

Cumulative Incidence ◽

Proportional Hazards ◽

Current Knowledge ◽

Cryptogenic Stroke ◽

Cox Proportional Hazards ◽

Kaplan Meier ◽

Artery Disease

Introduction: The incidence of atrial fibrillation (AF) is lower among non-whites compared to whites, despite a higher burden of AF risk factors. Current knowledge of first detection of AF after cryptogenic stroke (CS) by an implantable cardiac monitor (ICM) is based on a predominantly white cohort. The incidence of new AF after CS among minorities is unknown. We hypothesized that the incidence of AF after CS would be lower in non-whites. Methods: We reviewed charts of all patients without a history of AF undergoing implantation of an ICM after CS at our hospital from July 2014 to December 2019. Incidence of AF was identified through review of ICM monitoring for each patient, including adjudication of AF episodes for accuracy. Kaplan Meier survival analysis was performed, and cumulative incidence of AF using adjusted Cox proportional hazards regression was compared by race. Results: We identified 417 patients who underwent ICM implant after CS during the study period, with a mean follow-up time of 1.5 ± 1.1 years. Mean age was 62 ± 12 years, and 46% (n=190) were male. The majority of patients were non-white (white, 15%, n=63; black, 59%, n=244; Hispanic, 26%, n=110). At baseline, blacks, Hispanics, and whites were of similar age (mean 62.2, 62.1, and 61.5 years, respectively), and blacks and Hispanics had more AF risk factors, including heart failure, hypertension, diabetes, chronic kidney disease, and higher BMI, than whites. Hispanics had more coronary artery disease than whites and blacks (25.5%, 17.5%, 9.1% respectively, p < 0.001). Among blacks, the cumulative incidence of newly detected AF at one, two, and three years was 13.0%, 18.9%, and 23%, which was similar to Hispanics (12.9%, 18.2%, and 20.9%). By comparison, the incidence in whites was significantly higher (20.8%, 34.3%, 40.3%; blacks p=0.02; Hispanics p=0.01) Conclusion: In patients undergoing ICM after CS, the incidence of newly detected AF is approximately double in whites compared to both blacks and Hispanics.

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