Predictors of atrial fibrillation after off-pump coronary artery bypass graft surgery.
BACKGROUND
Postoperative atrial fibrillation (AF) is one of the most common complications after cardiothoracic surgery and is associated with an increased risk of stroke, and longer hospital stay. The pathophysiology of postoperative AF is uncertain, and its prevention remains unsatisfactory. Many previous studies have examined the predictors of AF after on-pump coronary artery bypass graft surgery (CABG), but there are few reports after off-pump CABG.


METHODS
The aim of the present prospective observational study, in which 296 consecutive patients were enrolled, was to elucidate the predictors of AF after off-pump CABG. The association of perioperative factors with AF was investigated using univariate analysis. Significant variables were included into a stepwise logistic regression model to ascertain their independent influence on the occurrence of AF.


RESULTS
The incidence of AF was 32%. AF prolonged the time until patients were fit for discharge by 3 days (P<0.01). Stepwise multivariate analysis identified increasing age [odds ratio (OR) 1.44 per 10-yr increase; 95% confidence interval (CI) 1.06-1.95], intraoperative average core temperature (OR 1.64; 95% CI 1.05-2.56), the average cardiac index in the intensive care unit (OR 0.37; 95% CI 0.19-0.71), and intraoperative fluid balance (OR 0.96 per 100-ml increase; 95% CI 0.93-0.99) as independent predictors of postoperative AF.


CONCLUSIONS
Our present findings indicate that ageing, the intraoperative fluid balance, and postoperative cardiac index are associated with the onset of AF after off-pump CABG.
Hosokawa
K
K
Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
Nakajima
Y
Y
Umenai
T
T
Ueno
H
H
Taniguchi
S
S
Matsukawa
T
T
Mizobe
T
T
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000209:etiology*; D001831:Body Temperature; D002302:Cardiac Output; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D014882:Water-Electrolyte Balance