Predictive factors of atrial fibrillation after coronary artery bypass grafting

Folla, Cynthia de Oliveira; Melo, Cinthia Cristina de Santana; Silva, Rita de Cassia Gengo e

doi:10.1590/s1679-45082016ao3673

Cited by 17 publications

(18 citation statements)

References 22 publications

(31 reference statements)

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“…The strongest predictors for POAF are age, longer ventilation requirement (not less than 24 hours), utilization of cardiopulmonary bypass and preoperative arrhythmias 26,27 . Kalman et al [28][29][30] reported that the POAF arm of a study on patients who underwent CABG surgery showed elevated norepinephrine levels, which suggested sympathetic activation.…”

Section: Discussionmentioning

confidence: 99%

Predictability of Atrial Fibrillation in Patients having Coronary Artery Bypass Graft Surgery, Based on Selvester Score

Uysal¹,

Kuyumcu²

2021

NKTD

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Aim: Patients having coronary artery bypass graft (CABG) surgery are influenced mostly by atrial fibrillation (AF), with the peak incidence of 16-44%. Due to post-operative AF (POAF), patients may be hospitalized for longer periods, require intensive care unit care again, necessitate more healthcare resources and even undergo congestive heart failure or stroke. Recent studies have shown that the size of the ventricular scar might be used as an indicator in the pathophysiology of AF. Selvester score was developed for the measurement of myocardial scar volume in patients with abnormal ventricular conduction, reporting its prognostic value in AF. Thus, we aim to investigate a likely relationship of POAF and the Selvester scoring system. Materials and Methods:This retrospective study included 180 patients with CABG from 2017 August to 2018 September. The obtained data had been analyzed in separate cohort of patients with POAF (n=50) and with post-operative sinus rhythm (PSR) (n=130). Intergroup comparisons were made using Selvester scores in particular. Results:The POAF group had higher Selvester scores (p<0.001), score of SYNTAX (p=0.039), serum high-sensitivity C-reactive protein levels (p=0.026), mean age (p<0.001), hypertrophy of left ventricul (LVH) (p=0.019) and hypertension (p=0.007) and decrased ejection fraction (LVEF) (p<0.001) than the PSR group. Logistic multivariable regression analyses showed that there were an independent association of LVH (p=0.041), LVEF (p=0.004), older age (p=0.008) and higher Selvester score (p<0.001) with POAF. Conclusion:Higher scores in Selvester scoring system are closely related to POAF, and Selvester score is a potential indicator for POAF.

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Section: Discussionmentioning

confidence: 99%

Predictability of Atrial Fibrillation in Patients having Coronary Artery Bypass Graft Surgery, Based on Selvester Score

Uysal¹,

Kuyumcu²

2021

NKTD

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“…FA é a arritmia supraventricular mais comum na prática clínica, ocasionada por uma desordem eletrofisiológica na comunicação entre o nó sinoatrial e os átrios, com focos ectópicos atriais que tentam conduzir o ritmo cardíaco, levando-os à frequência dos batimentos cardíacos irregulares em torno de 350 bpm. Deste modo, os átrios perdem a função de contração e passam a "fibrilar" (6,(8)(9)(10)(11) . Os registros eletrocardiográficos evidenciam ondas f (fibrilatórias) no traçado, variando sua forma e também sua amplitude (9) .…”

Section: Introductionunclassified

“…Deste modo, os átrios perdem a função de contração e passam a "fibrilar" (6,(8)(9)(10)(11) . Os registros eletrocardiográficos evidenciam ondas f (fibrilatórias) no traçado, variando sua forma e também sua amplitude (9) . Cerca de 30% dos pacientes são assintomáticos, porém, nesse caso, podem apresentar as seguintes manifestações clínicas: palpitações, síncope, complicações embólicas, poliúria, pulso irregular e cansaço (3,5) .…”

Section: Introductionunclassified

Fibrilação Atrial Em Pacientes Submetidos À Hemodiálise Contínua

2019

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Objetivo: descrever a prevalência de fibrilação atrial, o perfil epidemiológico e o tratamento utilizado em pacientes submetidos à hemodiálise contínua.Método: estudo quantitativo, transversal, realizado em 2017, com 110 pacientes internados num Centro de Terapia Intensiva de hospital privado de grande porte de Porto Alegre.Resultados: evidenciaram-se 36 (32,7%) ocorrências de fibrilação atrial durante a hemodiálise, com predominância da raça branca, sexo masculino em 25 (69,4%) e idade média de 75,2 ± 10,5. Verificou-se que 22 (61,1%) desencadearam o primeiro episódio de Fibrilação Atrial. A hipertensão arterial sistêmica e a obesidade foram as comorbidades de maior prevalência. Houve evidência maior de cardioversão química em 30 e elétrica em seis pacientes.Conclusão: evidenciou-se alta prevalência de fibrilação atrial em pacientes submetidos à hemodiálise contínua, o que denota a necessidade de competências específicas dos profissionais para a identificação, manejo das intercorrências cardiológicas e registros de qualidade acerca dos eventos.

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“…9,10,13 Recently, a study demonstrated that left atrial (LA) size was the best variable to discriminate between patients with or without POAF. 14 To our knowledge, no study has assessed the contribution of LA size evaluation to the predictive ability of those scores. The objectives of this study were to verify the predictive capacity of the CHADS 2 and CHA 2 DS 2 -VASc scores for the onset of POAF in patients submitted to coronary artery bypass grafting and/or valvular surgery; and to assess the contribution of LA size to the predictive capacity of these scores.…”

Section: Introductionmentioning

confidence: 99%

Left Atrial Size Contribution to the Predictive Capacity of Two Scores for Atrial Fibrillation in the Postoperative Period of Cardiac Surgeries

Silva

Butcher

2019

International Journal of Cardiovascular Sciences

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Background: Postoperative atrial fibrillation (POAF) is a common complication associated with undesirable outcomes; hence, the provision of appropriate tools is important to help identify patients at risk. Objectives:To evaluate the predictive capacity of the CHADS 2 and CHA 2 DS 2 -VASc scores, alone and combined with left atrial (LA) size, for the onset of POAF in patients undergoing coronary artery bypass grafting and/or valvular surgery. Methods:We performed a retrospective cohort study on 144 patients. A decision tree was used to identify the cut-off values of the CHADS 2 and CHA 2 DS 2 -VASc scores and LA size in order to calculate sensitivity, specificity, predictivevalue positive (PVP), and predictive-value negative (PVN), in addition to regression models. The receiver operating characteristic (ROC) curve was used to estimate the accuracy of the models. The level of significance adopted was 5%.Results: Patients who developed POAF were older (p = 0.050), had reduced left ventricular ejection fraction (p = 0.045), longer hospital length of stay (p = 0,018), but their mean CHADS 2 (p = 0.077) and CHA 2 DS 2 -VASc (p = 0.109) scores were similar to those of patients with no arrhythmia. LA size improved the predictive capacity of the CHADS 2 score, in terms of specificity and PVP, and of the CHA 2 DS 2 -VASc score, in terms of sensitivity and PVN. However, the CHADS 2 (OR = 1.198; CI95% = 0.859-1.156) and CHA 2 DS 2 -VASc (OR = 1.047; CI95% = 0.784-1.401) scores were not predictors of POAF, either alone or in combination with LA size (OR = 1.163; CI95% = 0.829-1.648 and OR = 1.065; CI95% = 0.795-1.433). Conclusion:The CHADS 2 and CHA 2 DS 2 -VASc scores alone or in combination with LA size did not show good predictive capacity for POAF.

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Predictive factors of atrial fibrillation after coronary artery bypass grafting

Cited by 17 publications

References 22 publications

Predictability of Atrial Fibrillation in Patients having Coronary Artery Bypass Graft Surgery, Based on Selvester Score

Predictability of Atrial Fibrillation in Patients having Coronary Artery Bypass Graft Surgery, Based on Selvester Score

Fibrilação Atrial Em Pacientes Submetidos À Hemodiálise Contínua

Left Atrial Size Contribution to the Predictive Capacity of Two Scores for Atrial Fibrillation in the Postoperative Period of Cardiac Surgeries

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