Predictors of atrial fibrillation following coronary artery bypass surgery

Abstract

SummaryBackgroundNew-onset atrial fibrillation is the most common form of rhythm disturbance following coronary artery bypass grafting surgery (CABG). It is still unclear which factors have a significant impact on its occurrence after this procedure. The aim of this study was to evaluate clinical predictors of postoperative atrial fibrillation (POAF) after myocardial revascularization.Material/MethodsWe performed a retrospective analysis of 322 patients who underwent the first CABG operation without baseline atrial fibrillation. All subjects underwent laboratory blood tests, echocardiography and selective coronarography with ventriculography. Patients were continuously electrocardiographically monitored during the first 48–72h after the operation for the occurrence of POAF.ResultsPOAF was diagnosed in 72 (22.4%) of the patients. Multivariate logistic regression analysis was used to identify the following independent clinical predictors of POAF: age ≥65 years (OR 1.78; 95%CI: 1.06–2.76; p=0.043), hypertension (OR 1.97; 95%CI: 1.15–3.21; p=0.018), diabetes mellitus (OR 2.09; 95% CI: 1.31–5.33; p=0.010), obesity (OR 1.51; 95%CI: 1.03–3.87; p=0.031), hypercholesterolemia (OR 2.17, 95%CI: 1.05–4.25; p=0.027), leukocytosis (OR 2.32, 95%CI: 1.45–5.24; p=0.037), and left ventricular segmental kinetic disturbances (OR 3.01; 95%CI: 1.65–4.61, p<0.001).ConclusionsThis study demonstrates that advanced age, hypertension, diabetes, obesity, hypercholesterolemia, leukocytosis, and segmental kinetic disturbances of the left ventricle are powerful risk factors for the occurrence of POAF.

A retrospective study on atrial fibrillation after coronary artery bypass grafting surgery at The National Heart Institute, Kuala Lumpur

“…Pre-operative co-morbid conditions, such as hypertension, diabetes, hypercholesterolemia and COPD, were also shown in previous studies to be independent predictors of POAF 45– 47 ; however this association could not be established in our study.…”

The Influence of the Metabolic Syndrome on Atrial Fibrillation Occurrence and Outcome after Coronary Bypass Surgery: A 3-Year Follow-up Study

“…4 On the contrary, our previous study showed that hypertension, diabetes, and obesity were independently associated with POAF onset. 5 However, at that time we did not investigate the influence of the MS on the POAF occurrence after CABG. The present study shows that the MS is not only independently associated with the POAF in patients who underwent CABG surgery but also associated with POAF irrespective of hypertension, diabetes, and obesity which represents a new finding.…”

“…1 The metabolic syndrome (MS) represents a cluster of cardiovascular risk factors (hypertension, obesity, diabetes, and dyslipidemia), and each of them could induce POAF. [2][3][4][5] In the past several years, the impact of the MS on POAF occurrence and short-term outcome in the patients who underwent coronary artery bypass grafting (CABG) has been investigated in a few studies. [6][7][8] However, none of these studies did provide follow-up of longer than 30 days after CABG.…”

Rhythm Disturbance After Myocardial Revascularization

“…Hypokalemia is more often associated with ventricular tachyarrhythmias, and the development of perioperative ventricular arrhythmias. One of the tasks of this study was how to prevent the occurrence of POAF ( 19 ). The most common drug used to treat POAF in our institution is Amiodarone.…”