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Published on: February 26, 2013
Predictors of early postoperative atrial fibrillation after off-pump myocardial revascularization
Sotirios Prapas1, Dimitra C Karatza, Ioannis Panagiotopoulos
1From the *Department of Cardiothoracic Surgery, the †Intensive Care Unit, the ‡Anesthesiology Department, and the §Department of Cardiology, Henry Dunant Hospital, Athens, Greece.
Insights
Atrial fibrillation (AF) affects about 20% of patients after off-pump coronary artery bypass grafting (OP-CAB). Older age, hypertension, and bilateral internal mammary artery use increase AF risk.
Area of Science:
- Cardiology
- Thoracic Surgery
- Cardiac Surgery
Background:
- Atrial fibrillation (AF) is a common complication after cardiac surgery.
- Off-pump coronary artery bypass grafting (OP-CAB) aims to reduce surgical trauma.
- Understanding AF incidence and risk factors in OP-CAB is crucial for patient management.
Purpose of the Study:
- To determine the incidence of atrial fibrillation (AF) following aorta nontouch coronary artery bypass grafting without extracorporeal circulation (OP-CAB).
- To identify predisposing factors for early postoperative AF in patients undergoing OP-CAB.
Main Methods:
- Prospective enrollment of 1359 patients undergoing OP-CAB between February 2001 and November 2005.
- Collection of demographic data, perioperative variables, and comorbidities.
- 24-hour rhythm monitoring until hospital discharge to detect AF.
Main Results:
- The incidence of early postoperative AF was 20.1% (273 out of 1359 patients).
- Patients who developed AF were significantly older (mean age 68.3 vs. 63.9 years).
- Predisposing factors identified by logistic regression included older age, history of arterial hypertension, and use of bilateral internal mammary arteries.
Conclusions:
- Atrial fibrillation occurs in approximately 20% of patients undergoing OP-CAB.
- Older age, arterial hypertension, and bilateral internal mammary artery grafts are significant predisposing factors for AF after OP-CAB.
Objective:
: We determined the incidence and the predisposing factors of atrial fibrillation (AF) after aorta nontouch coronary artery bypass grafting without extracorporeal circulation.
Methods:
: From February 2001 to November 2005, 1359 patients (1159 men, 85.3%) of mean (±SD) age 64.8 (±9.8) years, who underwent off-pump coronary artery bypass grafting (OP-CAB), were prospectively enrolled. Demographics, perioperative data, and comorbidities were recorded in all patients. A 24-hour rhythm monitoring was performed in all patients until hospital discharge.
Results:
: Among 1359 patients, 273 (20.1%) had development of atrial fibrillation in the early postoperative period. Patients with AF had higher mean (±SD) age, 68.3 (±8.8) years, compared with control subjects [63.9 (±9.9)] (P ≤ 0.0005). Univariate analysis showed that apart from age, history of arterial hypertension (P ≤ 0.02), chronic obstructive pulmonary disease (P ≤ 0.02), and the use of bilateral internal mammary arteries (P ≤ 0.01) were predisposing factors for the development of AF. Logistic regression analysis showed that age, history of arterial hypertension, and the use of bilateral internal mammary arteries were predisposing factors for early postoperative AF after OP-CAB.
Conclusions:
: Atrial fibrillation occurred in approximately 20% of patients undergoing OP-CAB, mainly in older patients with arterial hypertension who received bilateral internal mammary artery grafts.
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