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Published on: February 26, 2013
Postoperative Atrial Fibrillation Following Isolated Coronary Artery Bypass Grafting: Incidence, Predictors, and
Mehmet Rum1, Halit Er2, Fatmagul Yilmaz3
1Department of Cardiovascular Surgery, Kosuyolu High Specialisation Education and Research Hospital, University of Health Sciences, Istanbul, Turkiye.
Insights
Postoperative atrial fibrillation (POAF) is common after coronary artery bypass grafting (CABG). Advanced age, reduced kidney function, and longer cross-clamp times increase POAF risk, leading to higher mortality and morbidity.
Area of Science:
- Cardiovascular Surgery
- Nephrology
- Critical Care Medicine
Background:
- Atrial fibrillation (AF) is a prevalent arrhythmia.
- Coronary artery bypass grafting (CABG) is a common cardiac surgical procedure.
- Postoperative atrial fibrillation (POAF) is a significant complication following cardiac surgery.
Purpose of the Study:
- To determine the incidence of POAF after isolated CABG.
- To assess the impact of POAF on mortality and morbidity.
- To identify demographic and comorbid factors associated with POAF onset.
Main Methods:
- An observational cohort study was conducted.
- Data from 489 patients undergoing isolated CABG were analyzed.
- Exclusion criteria included valvular heart disease and prior AF history.
Main Results:
- Age, chronic renal disease, and reduced glomerular filtration rate (GFR) were associated with POAF.
- Prolonged cross-clamp time, but not cardiopulmonary bypass duration, correlated with POAF.
- POAF increased the risk of acute kidney injury, infection, prolonged intubation, need for inotropic support, and mortality.
Conclusions:
- POAF is a frequent complication after isolated CABG.
- Risk factors include advanced age, reduced GFR, chronic kidney disease, and prolonged cross-clamp time.
- POAF is linked to adverse postoperative outcomes, including increased mortality.
Objective:
To investigate the incidence of postoperative atrial fibrillation (POAF) in patients following isolated coronary artery bypass grafting (CABG), evaluate its impact on mortality and morbidity, and analyse demographic and comorbid variables associated with its onset.
Study Design:
Observational cohort study. Place and Duration of the Study: Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye, from June 2020 to December 2022.
Methodology:
Patients who underwent isolated CABG were included in the study. Those diagnosed with valvular heart disease on echocardiography were excluded, as were those with a history of atrial fibrillation (AF).
Results:
Statistical analysis was conducted on data from 489 patients. Among the demographic factors examined, only age (p = 0.021) exhibited a significant correlation with the development of POAF. Chronic renal disease (p = 0.044) and reduced glomerular filtration rate (GFR) levels (p = 0.020) were significantly associated with POAF. Regarding perioperative factors, cardiopulmonary bypass (CPB) duration (p = 0.104) was not significantly related to POAF, whereas prolonged cross-clamp time was (p = 0.009). POAF was associated with postoperative complications, including acute kidney damage (p = 0.002), extended intubation (p = 0.003), infection (p <0.001), the need for intra-aortic balloon pump (IABP) or inotropic support (p = 0.004), and mortality (p = 0.001).
Conclusion:
POAF is a common complication after isolated CABG and is significantly associated with advanced age, reduced GFR, chronic kidney disease, and prolonged cross-clamp time. Its occurrence is associated with increased postoperative morbidity and mortality. These findings emphasise the importance of perioperative risk factors in predicting adverse outcomes.
Key Words:
Atrial fibrillation, Coronary artery bypass, Acute kidney injury, Mortality, Morbidity, Intra-aortic balloon pumping.
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