Predictors of atrial fibrillation occurrence after coronary artery bypass graft surgery

Abstract

Postoperative atrial fibrillation (AF) is the most common complication after coronary artery bypass graft (CABG) surgery, with an incidence of 20%-50%. The objective of this study was to investigate perioperative risk factors of postoperative sustained AF by the way of logistic regression analysis. Data for the last 98 patients who had undergone CABG surgery before January 2010 were retrospectively collected and analyzed. Postoperative sustained AF was detected in 34 (34.7%) patients. Mean arterial blood pressure, previous hypertension (HT), previous AF, previous chronic obstructive pulmonary disease, aortic cross-clamp time, cardiopulmonary bypass time, postoperative urea, postoperative creatinine, postoperative potassium, extubation time, chest tube drainage, units of transfused packed red blood cells (pRBC), and postoperative pneumonia were associated with higher occurrence of postoperative sustained AF according to the univariate analysis. Upon logistic regression analysis, pRBC transfusion, previous AF, and preoperative HT remained independent predictors for the development of postoperative sustained AF. On-pump versus off-pump CABG is not significantly associated with AF development so long as the operating time does not extend over a certain time period. pRBC transfusion was the single risk factor that is amenable to intervention at the time of operation. Unneeded transfusion of pRBCs must be prohibited. Also, serious precautions must be taken against postoperative pneumonia to avoid postoperative AF occurrence.