[Atrial fibrillation after coronary artery bypass surgery. The significance of preoperative vagus modulation and ectopic atrial activity].
To investigate the impact of pre-operative autonomic balance and atrial ectopic activity on the risk of atrial fibrillation or flutter after aorto-coronary artery bypass surgery 24-hour Holter monitoring was analyzed in 102 patients before coronary artery bypass grafting. Index for vagal tone was calculated as % successive RR-interval differences > 6%. Twenty-nine (28%) of the 102 patients developed atrial fibrillation or flutter. Independent predictors (90% confidence interval) of postoperative atrial fibrillation or flutter were identified by logistic regression analysis: the independent predictors were older age, relative risk 1.07/year (1.02-1.12), vagal index < 10%, relative risk 4.50 (1.40-14.5), > or= 10 ectopic supraventricular beats/24 hour, relative risk 3.03 (1.05-8.72), and one or more event of non-sustained supraventricular tachycardia, relative risk 3.02 (1.11-8.22). Thus, age of the patient, attenuated preoperative cardiac vagal modulation, ectopic supraventricular beats, and paroxysmal non-sustained supraventricular tachycardia are independent risk factors for the development of atrial fibrillation or flutter after coronary artery bypass surgery.
Frost
L
L
Hjertemedicinsk afdeling B, Skejby Sygehus, Arhus.
Mølgaard
H
H
Christiansen
E H
EH
Jakobsen
C J
CJ
Allermand
H
H
Thomsen
P E
PE
D001281:Atrial Fibrillation / Q000209:etiology* / Q000517:prevention & control; D001282:Atrial Flutter / Q000209:etiology / Q000517:prevention & control; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care; D011446:Prospective Studies; D012307:Risk Factors; D013612:Tachycardia, Ectopic Atrial / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D014630:Vagus Nerve / Q000502:physiology
Atreiflimren efter koronar bypass-kirurgi. Betydningen af proeoperativ vagusmodulation og ektopisk atrieaktivitet.