title: Prediction of atrial fibrillation after off-pump coronary artery bypass grafting using preoperative total atrial conduction time determined on tissue Doppler imaging.
abstract: BACKGROUND
  Postoperative atrial fibrillation (POAF) is a common complication of cardiac surgery and results in increased health-care utilization. This study identified new transthoracic echocardiographic predictors of POAF using an index of the total atrial conduction time derived on tissue Doppler imaging (PA-TDI duration) in patients undergoing off-pump coronary artery bypass grafting (OPCAB).
  
  
  RESULTS
  A total of 88 patients undergoing isolated OPCAB were enrolled. They were examined preoperatively on transthoracic echocardiography with tissue Doppler evaluations and monitored postoperatively with continuous electrocardiographic telemetry for 7 days. POAF occurred in 35 patients (39.8%). Patients with POAF had a significantly longer duration of hospital stay than those without (44.9±6.2 vs. 37.3±3.3 days, P=0.04). Multivariate analysis showed that PA-TDI duration (odds ratio [OR], 1.11; 95% confidence interval [CI]: 1.06-1.16; P=0.0001) and left atrial volume index (LAVI; OR, 1.11; 95% CI: 1.02-1.20; P=0.01) were independent predictors of POAF. Moreover, PA-TDI duration was more reliable, given an area under the receiver operating characteristic curve of 0.85 (sensitivity, 74.3%; specificity, 86.8%).
  
  
  CONCLUSIONS
  PA-TDI duration was an independent predictor of POAF following OPCAB. Awareness of risk of POAF may lead to the prevention of POAF, a rapid response to POAF, shortened hospital stay, and improved prognosis.
authors.affiliation: Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences.
authors.forename: Mai
authors.initials: M
authors.lastname: Fujiwara
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Nakano
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hidaka
authors.forename: Noboru
authors.initials: N
authors.lastname: Oda
authors.forename: Yuko
authors.initials: Y
authors.lastname: Uchimura
authors.forename: Akinori
authors.initials: A
authors.lastname: Sairaku
authors.forename: Kenta
authors.initials: K
authors.lastname: Kajihara
authors.forename: Takehito
authors.initials: T
authors.lastname: Tokuyama
authors.forename: Chikaaki
authors.initials: C
authors.lastname: Motoda
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ikenaga
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Imai
authors.forename: Taijirou
authors.initials: T
authors.lastname: Sueda
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Kihara
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D047549:Coronary Artery Bypass, Off-Pump; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors