title: Preoperative Electrocardiogram Score for Predicting New-Onset Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery.
abstract: OBJECTIVE
  To investigate if electrocardiogram (ECG) markers from routine preoperative ECGs can be used in combination with clinical data to predict new-onset postoperative atrial fibrillation (POAF) following cardiac surgery.
  
  
  METHODS
  Retrospective observational case-control study.
  
  
  METHODS
  Single-center university hospital.
  
  
  METHODS
  One hundred consecutive adult patients (50 POAF, 50 without POAF) who underwent coronary artery bypass grafting, valve surgery, or combinations.
  
  
  METHODS
  Retrospective review of medical records and registration of POAF.
  
  
  RESULTS
  Clinical data and demographics were retrieved from the Western Denmark Heart Registry and patient records. Paper tracings of preoperative ECGs were collected from patient records, and ECG measurements were read by two independent readers blinded to outcome. A subset of four clinical variables (age, gender, body mass index, and type of surgery) were selected to form a multivariate clinical prediction model for POAF and five ECG variables (QRS duration, PR interval, P-wave duration, left atrial enlargement, and left ventricular hypertrophy) were used in a multivariate ECG model. Adding ECG variables to the clinical prediction model significantly improved the area under the receiver operating characteristic curve from 0.54 to 0.67 (with cross-validation). The best predictive model for POAF was a combined clinical and ECG model with the following four variables: age, PR-interval, QRS duration, and left atrial enlargement.
  
  
  CONCLUSIONS
  ECG markers obtained from a routine preoperative ECG may be helpful in predicting new-onset POAF in patients undergoing cardiac surgery.
authors.affiliation: Department of Cardiothoracic Surgery, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Cardiovascular Surgery, Heart Centre of General Hospital, Ningxia Medical University, Yinchuan, Ningxia, Peoples Republic of China; Atrial Fibrillation Study Group, Aalborg University Hospital, Aalborg, Denmark. Electronic address: g.jiwei@rn.dk.
authors.forename: Jiwei
authors.initials: J
authors.lastname: Gu
authors.affiliation: Department of Cardiothoracic Surgery, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Atrial Fibrillation Study Group, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Andreasen
authors.affiliation: Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Melgaard
authors.affiliation: Atrial Fibrillation Study Group, Aalborg University Hospital, Aalborg, Denmark; Unit of Clinical Biostatistics and Bioinformatics, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Lundbye-Christensen
authors.affiliation: Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: John
authors.initials: J
authors.lastname: Hansen
authors.affiliation: Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Atrial Fibrillation Study Group, Aalborg University Hospital, Aalborg, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Erik B
authors.initials: EB
authors.lastname: Schmidt
authors.affiliation: Department of Cardiothoracic Surgery, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Kristinn
authors.initials: K
authors.lastname: Thorsteinsson
authors.affiliation: Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: Claus
authors.initials: C
authors.lastname: Graff
mesh_terms: D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006351:Heart Valves / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D012372:ROC Curve; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors
keywords: cardiac surgery; electrocardiogram characteristics; new-onset postoperative atrial fibrillation