Predictors of atrial fibrillation in patients undergoing surgery for ischemic heart disease.
OBJECTIVE
Atrial fibrillation (AF) remains a common problem after cardiac surgery. AF increases the risk for stroke and is associated with increased length of hospitalization. The aim of this study was to analyze risk factors for postoperative AF in a uniformly managed cohort of patients.


METHODS
The records of 775 consecutive patients undergoing coronary artery bypass grafting (CABG) or CABG + valve procedures were examined. Forward stepwise multiple logistic regression analysis was used for statistical evaluation.


RESULTS
Mean age was 64.6 +/- 8.7 years. The incidence of AF was 29.1% in patients undergoing isolated CABG and 48.6% after CABG + valve procedures. Multivariate analysis identified advanced age (p = 0.000003), low postoperative mixed venous oxygen saturation (p = 0.0018), hypertension (p = 0.0059), preoperative history of AF (p = 0.023) and the need for mechanical circulatory support (p = 0.030) as predictors for postoperative AF.


CONCLUSIONS
In agreement with previous studies, advanced age was the most important predictor of AF. Hypertension, history of AF and signs of circulatory failure were also predictive of AF. Preventive measures against AF should preferably be tested in high-risk populations, such as elderly patients.
Svedjeholm
R
R
Department of Cardiothoracic Surgery, University Hospital, Linköping, Sweden. Rolf.Svedjeholm@lio.se
Håkanson
E
E
D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors