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Heart rate variability measures poorly predict atrial fibrillation after off-pump coronary artery bypass grafting

Dmitri Chamchad1, Jay C Horrow, Louis E Samuels

  • 1Department of Anesthesia, Lankenau Hospital and Lankenau Institute of Medical Research, Wynnewood, PA 19096, USA.

Journal of Clinical Anesthesia
|September 14, 2011
PubMed

Insights

Postoperative atrial fibrillation (AF) occurred in nearly half of patients after off-pump coronary artery bypass grafting (CABG). Heart rate variability (HRV) analysis showed limited predictive value for AF in this patient group.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Physiology

Background:

  • Postoperative atrial fibrillation (AF) is a common complication after cardiac surgery.
  • Off-pump coronary artery bypass grafting (CABG) is performed to reduce surgical trauma.
  • The predictive value of heart rate variability (HRV) for AF after off-pump CABG is not well established.

Purpose of the Study:

  • To investigate the association between preoperative heart rate variability (HRV) measurements and the occurrence of postoperative atrial fibrillation (AF).
  • To assess the utility of different HRV analysis domains (time, frequency, non-linear) in predicting AF after off-pump CABG.

Main Methods:

  • A prospective, observational study involving 50 patients undergoing off-pump CABG.
  • Preoperative electrocardiograms (ECGs) were analyzed for HRV. Postoperative ECG telemetry was monitored for 5 days.
  • Analyses included time and frequency domain HRV, non-linear HRV determinations, and multivariate regression.

Main Results:

  • Postoperative AF occurred in 46% of patients.
  • Only the low to high-frequency ratio of HRV showed a statistically significant association with AF (P < 0.05).
  • Non-linear HRV analyses did not demonstrate significant predictive value for AF.

Conclusions:

  • The off-pump surgical approach does not prevent the occurrence of postoperative AF.
  • Standard and non-linear HRV analyses have limited value in predicting AF after off-pump CABG.
  • Further research may be needed to identify reliable predictors of AF in this population.
Abstract

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