title: Clinical and echocardiographic predicators of postoperative atrial fibrillation.
abstract: BACKGROUND
  Postoperative atrial fibrillation is the most common arrhythmia after coronary artery bypass grafting, with a reported incidence of 10% to 60%. Preoperative clinical and echocardiographic data, especially the atrial electromechanical interval, predict postoperative atrial fibrillation in elective coronary artery bypass patients.
  
  
  METHODS
  A prospective study evaluated preoperative clinical and echocardiographic data in 192 patients who underwent elective coronary artery bypass from 2010 to 2012.
  
  
  RESULTS
  18 (9.37%) patients developed postoperative atrial fibrillation. Compared to patients without postoperative atrial fibrillation, these 18 had significantly longer intensive care unit and hospital stays, they were significantly older (58.62 ± 10.02 vs. 53.22 ± 8.23 years; p = 0.02), with a larger left atrial volume (83.39 ± 8.31 vs. 55.47 ± 8.37 cm(3), p = 0.001), longer atrial electromechanical interval (133.67 ± 8.15 vs. 98.05 ± 6.71 ms p < 0.0001), and lower tissue Doppler imaging systolic velocity wave amplitude (6.6 ± 1 vs. 9.4 ± 2.2 cm·s(-1); p = 0.001); they also had a higher prevalence of hypertension (61.11% vs. 38.5%; p = 0.04). Using 115 ms as the cutoff value of atrial electromechanical interval enabled us to detect patients who developed postoperative atrial fibrillation with 100% sensitivity, 77% specificity, 78% positive predictive value, and 100% negative predictive value.
  
  
  CONCLUSIONS
  Older hypertensive patients are at higher risk of developing postoperative atrial fibrillation. Preoperative measurement of atrial electromechanical interval by tissue Doppler echocardiography is a useful predictor of postoperative atrial fibrillation in coronary artery bypass patients.
authors.affiliation: Saud Al-Babtain Cardiac Center, Dammam, Saudi Arabia Cardiothoracic Surgery Department, Banha Faculty of Medicine, Banha University, Egypt mohamedawady@yahoo.com.
authors.forename: Mohamed Ahmed
authors.initials: MA
authors.lastname: Elawady
authors.affiliation: Saud Al-Babtain Cardiac Center, Dammam, Saudi Arabia Cardiology Department, Faculty of Medicine, Alazhar University, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Bashandy
mesh_terms: D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D015150:Echocardiography, Doppler; D017558:Elective Surgical Procedures; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Atrial fibrillation; atrial function; blood flow velocity; coronary artery bypass; doppler; echocardiography; left