Predictors of postoperative atrial fibrillation after coronary artery bypass graft surgery.
OBJECTIVE
The present study was aimed to identify the preoperative, intraoperative, and postoperative predictors of AF in a pure cohort of the patients with coronary artery disease who underwent CABG surgery.


METHODS
Between November 2005 and May 2006, 302 consecutive patients were included in this prospective study. All the relevant clinical, electrocardiographic, echocardiographic, and laboratory data were gathered in the included patients and they were also monitored for development of post-CABG AF.


RESULTS
Postoperative AF occurred in 46 (15%) of patients. By univariate analysis, older age, P-wave abnormality in ECG, presence of mitral regurgitation, larger left atrium (LA), left main coronary artery involvement, failure to graft right coronary artery (RCA), and adrenergic use in ICU were significantly associated with occurrence of post-CABG AF (all P< 0.05). However, in the logistic regression model, age (OR: 1.067, 95%CI: 1.02-1.116, P=0.005), LA dimension (OR: 1.102, 95%CI: 1.017-1.1936, P=0.017), P-wave morphology (OR: 12.07, 95%CI: 3.35-48.22, P=0.0001), failure to graft RCA (OR: 3.57, 95%CI: 1.20-10.64, P=0.022), and postoperative adrenergic use (OR: 0.35, 95%CI: 0.13-0.93, P=0.036) remained independently predictive of postoperative AF.


CONCLUSIONS
The present study suggested that age, P-wave morphology, LA dimension, failure to graft right coronary artery, and postoperative adrenergic use were independent predictors of post-CABG AF. Therefore, clinical data, ECG and echocardiography may be useful in preoperative risk stratification of the surgical patients for the occurrence of post-CABG AF.
Haghjoo
Majid
M
Department of Pacemaker and Electrophysiology, Rajaie Cardiovascular Medical and ResearchCenter, Iran University of Medical Sciences, Tehran, Iran. majid.haghjoo@gmail.com
Basiri
Hossein
H
Salek
Mehrasa
M
Sadr-Ameli
Mohammad Ali
MA
Kargar
Faranak
F
Raissi
Kamal
K
Omrani
Gholamreza
G
Tabatabaie
Mohammad Bagher
MB
Sadeghi
Hassan Mirmohammad
HM
Tabaie
Ali Sadeghpour
AS
Baghaie
Ramin
R