Heart Rate Variability and Its Role in Predicting Atrial Fibrillation in Patients Undergoing Coronary Artery Bypass Graft
Related Experiment Video
Updated: Jul 11, 2025
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
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.
More Related Videos
Related Concept Videos
01:28Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
01:30Factors Influencing Heart Rate
Let us explore the significant factors affecting heart rate, including age, body temperature, posture, acute pain, chemical influences,...
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
01:29Dysrhythmias III: Characteristics of Dysrhythmias
01:30Acute Coronary Syndrome III: Diagnostic Studies