DETECTion of PeriOperative Atrial Fibrillation After Noncardiac Surgery

Prior treatment

• Known life expectancy \<1 year due to concomitant disease;
• Previously enrolled in DETECT-POAF.

Other illness

• History of documented chronic (i.e., non-transient) AF before noncardiac surgery;
• Severe renal insufficiency;
• Acute stroke in the past 14 days;
• Underwent cardiac surgery in the past 35 days;
• History of nontraumatic intracranial, intraocular, or spinal bleeding;
• Hemorrhagic disorder or bleeding diathesis;
• Known contact allergy to monitoring device and/or its peripheral components;

Other

• Need for long-term systemic anticoagulation;
• Ongoing need for long-term dual antiplatelet treatment;
• Contraindication to oral anticoagulation;
• Severe liver cirrhosis;
• Women who are pregnant, breastfeeding, or of childbearing potential not taking effective contraception;
• Expected to be non-compliant with follow-up and/or device use;

• Had undergone noncardiac surgery within the past 72 hours and requiring, or expected to require, at least one of the following:
  • an overnight hospital admission after surgery
  • day surgery that would result in a large enough physiological insult to be able to cause POAF. Procedures excluded include those that are conducted using local anesthesia alone, are less than 30 minutes in duration, and/or are judged to be of low physiologic insult by the local investigator.
• Have one of the following high-risk criteria;
  • age 55-64 years, and having either established cardiovascular disease, recent major vascular surgery, a CHA2DS2-VASc score ≥3, or an elevated postoperative troponin level;
  • age 65-74 years, and having either established cardiovascular disease, recent major vascular surgery, a CHA2DS2-VASc score ≥2, or an elevated postoperative troponin level; or
  • age ≥75 years;
• Provide written informed consent to participate.