Hemodynamic parameters predict the risk of atrial fibrillation after cardiac surgery in adults

Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery and is associated with poorer prognosis. This study attempted to evaluate whether hemodynamic parameters determined by a right heart catheter predict the occurrence of POAF.

We hypothesized that atrial fibrillation after cardiac surgery can be predicted by hemodynamic parameters determined by a right heart catheter.

Between October 2015 and January 2017, 126 patients with preoperative sinus rhythm undergoing coronary artery bypass grafting and/or aortic valve replacement were enrolled in this study. Complete echocardiographic examination was performed preoperatively, and hemodynamic parameters were recorded via a right heart catheter before anesthesia induction. Postoperative telemetry strips and electrocardiogram were used to detect atrial fibrillation until discharge. Multivariate logistic regression was used to identify risk factors of POAF.

The overall incidence of POAF was 40/126 (31.7%). Multivariate logistic regression analysis determined that left atrial dimension (LAD) (adjusted odds ratio [OR]: 1.118, 95% confidence interval [CI]: 1.020-1.227, P = 0.018), pulmonary capillary wedge pressure (PCWP) (adjusted OR: 1.225, 95% CI: 1.082-1.387, P = 0.001), and pulmonary artery systolic pressure (PASP) (adjusted OR: 1.076, 95% CI: 1.019-1.137, P = 0.008) were significant predictors of POAF.

The present study suggested that LAD, PCWP, and PASP were robust predictors of POAF. These parameters may indicate a patient's susceptibility toward developing POAF and help to identify patients who need preventive treatment.