Predictors of postoperative atrial fibrillation after coronary artery bypass grafting: a prospective observational cohort study

Hanaa A El-Gendy,Amr H Ali,Gamal M Elewa,Mohamed H Dabsha

doi:10.1186/s42077-020-00103-9

Hanaa A El-Gendy, Amr H Ali + Show 2 more

Open Access

https://doi.org/10.1186/s42077-020-00103-9

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Abstract

BackgroundThis study was conducted to determine the effect of certain predictors on the incidence of postoperative atrial fibrillation (POAF) during ICU stay after coronary artery bypass graft (CABG) surgery.ResultsWe enrolled 123 patients in this study. The mean age was 57.4 ± 8.7 years, and the mean left atrial diameter was 4.1 ± 0.52 cm with male preponderance (76.4%). The incidence of POAF following CABG was 33.3%. There was no statistically significant association between POAF and smoking (P = 0.123). However, POAF was significantly associated with higher CHA2DS2-VASc score (P = 0.002), valve replacement (P < 0.001), and inotropic support (P = 0.005). Moreover, patients with POAF had significantly higher mean age (P = 0.031) and left atrial (LA) diameter (P < 0.001). Logistic regression showed that LA diameter (P < 0.001), potassium level at 36 h (P = 0.016), and female gender (P = 0.001) were independent predictors of POAF.ConclusionsWe had several significant epidemiological, clinical, and operative variables that were significantly associated with post-CABG AF, including older age, female gender, large LA diameter, valve replacement, higher CHA2DS2-VASc score, and postoperative inotropic support. However, only LA diameter, female gender, and potassium level at 36 h were independent predictors of POAF. Nevertheless, further large-scale studies are needed to confirm our findings.

Highlights

Postoperative atrial fibrillation (POAF) is one of the most critical and common complications after cardiovascular surgery, precipitating early, and late morbidities
The percentage of female patients was significantly higher in the postoperative atrial fibrillation (POAF) group (43.9% vs 13.4%; P < 0.001)
Postoperative atrial fibrillation within the first 2 to 3 days after coronary artery bypass graft (CABG) is relatively common with recorded incidence of 20 to 50% and is associated with increased morbidity, higher risk of embolic stroke postoperatively, and increased mortality (Dobrev et al, 2019)

Summary

Introduction

Postoperative atrial fibrillation (POAF) is one of the most critical and common complications after cardiovascular surgery, precipitating early, and late morbidities. Incidence of POAF after coronary artery bypass graft (CABG) surgery is about 30%, about 40% after valve surgery, and about 50% after combined CABG and valve replacement/repair surgery, with peaks occurring two to 3 days after surgery (Chebbout et al, 2018). Multiple investigations and studies have tried to identify demographic risk factors and predictors of POAF after CABG with or without valve replacement (Dobrev et al, 2019). The aim of this study was to determine the effect of certain predictors on the incidence of. This study was conducted to determine the effect of certain predictors on the incidence of postoperative atrial fibrillation (POAF) during ICU stay after coronary artery bypass graft (CABG) surgery

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