Incidence and Predictors of New-Onset Silent Atrial Fibrillation after Coronary Artery Bypass Graft Surgery.
OBJECTIVE
We investigated the incidence, risk factors, and prognostic impact of silent atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery.


METHODS
This observational study prospectively included 100 patients referred for CABG surgery. Holter ECG monitoring was used to record every arrhythmic event for 7 days. AF was defined as at least one episode >30 s. Episodes recorded on Holter ECG monitoring but not clinically identified were classified as silent AF.


RESULTS
Among 34 patients who developed new-onset AF, 13 had silent AF. Compared with patients with maintained sinus rhythm (SR), silent AF patients had a significantly higher logistic EuroSCORE (2.9 (1.5-5.2) versus 2.3 (1.4-3.7), p = 0.017) and were more likely to have previous sleep apnea (31% versus 8%, p = 0.016) and left atrial diameter >45 mm (36% versus 5%, p = 0.002). At one-year follow-up, 30% of silent AF patients had developed symptomatic AF versus 7% in the SR group (p = 0.03) and 11% in the clinical AF group (p = 0.21).


CONCLUSIONS
After CABG surgery, silent AF is common and may be associated with a higher incidence of recurrences at one-year follow-up than clinical AF. Improved screening for silent AF may help to reduce thromboembolic events in this high-risk population.
University Hospital, Department of Cardiology, 21000 Dijon, France ; INSERM, U866, LPPCM, 21000 Dijon, France.
Charles
C
Guenancia
University Hospital, Department of Cardiothoracic Surgery, 21000 Dijon, France.
Charline
C
Pujos
University Hospital, Department of Cardiology, 21000 Dijon, France ; University Hospital, Department of Cardiothoracic Surgery, 21000 Dijon, France.
Frederique
F
Debomy
University Hospital, Department of Cardiothoracic Surgery, 21000 Dijon, France.
Ghislain
G
Malapert
University Hospital, Department of Cardiology, 21000 Dijon, France ; CNRS, UMR 5158, Le2I, 21000 Dijon, France.
Gabriel
G
Laurent
University Hospital, Department of Cardiothoracic Surgery, 21000 Dijon, France ; CNRS, UMR 5158, Le2I, 21000 Dijon, France.
Olivier
O
Bouchot
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology