Echocardiographic Predictors of Atrial Fibrillation after Coronary Artery Bypass Grafting

Abstract

Background Postoperative atrial fibrillation (POAF) complicates 20–40% of cardiac surgical procedures and 10–20% of non-cardiac thoracic operations. Typical features include onset at 2–4 days postoperatively, episodes that are often fleeting and a self-limited time course. Associated adverse consequences of POAF include hemodynamic instability, increased risk of stroke, lengthened hospital and intensive care unit stays and greater costs (Dobrev et al., 2019). Aim The aim of this work is to detect the echo-cardio graphic parameters for prediction of post-operative atrial fibrillation in patients with ischemic heart disease undergoing isolated coronary artery bypass graft. Methods One hundred patients with multivessel disease for CABG were prospectively enrolled; all of them were in sinus rhythm at the moment of enrollment. LA maximal volume, LV ejection fraction, LVESV &LVEDV and TDI were assessed. Moreover, LA strain and Left Ventricular Global Longitudinal Strain % were analyzed by speckle tracking technique. Patients were followed up for 1 week after surgery in order to identify occurrence of atrial fibrillation. Results We found a statistically significant difference between patients undergoing CABG who are older in age with mean ± SD 64.455 ± 6.254 in group I (AF) vs. 54.577 ± 6.710 in group II with p value <0.001*, we found also that patients undergoing CABG with POAF (group I) 50 % of them had left main diseases vs. 23% in group II (NSR) with other lesions (RCA&LCX), p value = 0.014*. Conclusions There is no significant difference between the two groups regarding conventional echo parameters, TDI & by speckle tracking technique (LA strain & LVGLS %). However, patients who developed POAF were older, & left main lesions are more likely to have left main lesions.