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Published on: July 20, 2022
Heart Rate Variability and Its Role in Predicting Atrial Fibrillation in Patients Undergoing Coronary Artery Bypass
Ngo Van Thanh1, Nguyen Sinh Hien1, Pham Nguyen Son2
1Hanoi Heart Hospital, Hanoi, Vietnam.
Insights
Reduced preoperative heart rate variability (HRV) predicts new-onset atrial fibrillation (AF) after coronary artery bypass grafting (CABG). An SDNN below 50 ms is a weak predictor of AF within six months post-surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Heart rate variability (HRV) is linked to cardiac events.
- The association between HRV and new-onset atrial fibrillation (AF) post-coronary artery bypass grafting (CABG) remains debated.
Purpose of the Study:
- To investigate the relationship between HRV and new-onset AF in patients undergoing CABG.
- To assess this association over a 6-month follow-up period.
Main Methods:
- Prospective study of 119 patients undergoing off-pump CABG.
- 24-hour Holter monitoring preoperatively and at 1 week, 3 months, and 6 months postoperatively.
- Analysis of HRV and detection of AF from recordings.
Main Results:
- NYHA III class increased postoperative AF rates at 7 days.
- Advanced age and diabetes were associated with AF at 6 months.
- Reduced preoperative time-domain HRV measurements predicted higher AF risk at 7 days.
- Preoperative HRV showed no association with AF at 6 months.
- Reduced HRV (SDNN < 50 ms) independently predicted AF at 3 and 6 months (AUC=0.65 and 0.62).
Conclusions:
- Reduced preoperative HRV is linked to higher early AF risk after CABG.
- Low SDNN (< 50 ms) is a weak predictor of AF incidence at 3 and 6 months post-CABG.
Background:
An association between heart rate variability (HRV) and cardiac events in certain diseases has been demonstrated. However, the association with new-onset atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is still controversial. This study aimed to investigate the association between HRV and new-onset AF in patients undergoing CABG during a 6-month follow-up.
Methods:
This prospective study included 119 consecutive patients who underwent off-pump CABG. All patients were assessed using 24-hour Holter recordings 2 days before CABG and 1 week, 3 months, and 6 months postoperatively. HRV was analyzed, and AF was detected from its recordings.
Main Results:
In patients undergoing CABG, NYHA III increased the AF rate 7 days postoperatively, and advanced age and diabetes were associated with AF 6 months postoperatively. A reduction in time-domain measurements before surgery was significantly associated with a higher risk of developing AF seven days postoperatively; no association between preoperative HRV and AF was found at six months. Reduced preoperative HRV (SDNN (standard deviation of all normal-to-normal intervals [) < 50 ms) was an independent predictor of AF at 3 (AUC = 0.65) and 6 months (AUC = 0.62) following surgery.
Conclusion:
A reduction in the time domain measurements before CABG was associated with a higher risk of new-onset AF at 7 days postoperatively but not at 6 months. An SDNN <50 ms was a weak independent predictor of a higher incidence of AF at 3 and 6 months post-surgery.
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