67. Clinical and echocardiographic predicators of postoperative atrial fibrillation

• Main Authors: Mohamed Elawadi, Mohamed Bashandi
• Format: Article
• Language: English
• Published: Saudi Heart Association 2015-10-01
• Series: Journal of the Saudi Heart Association
• Subjects: Atrial fibrillation; Atrial function; Left; Blood flow velocity; Coronary artery bypass; Echocardiography; Doppler
• Online Access: http://www.sciencedirect.com/science/article/pii/S1016731515003073

Postoperative atrial fibrillation is the most common arrhythmia after coronary artery bypass grafting, with a reported incidence of 10–60%. Preoperative clinical and echocardiographic data, especially the atrial electromechanical interval, predict postoperative atrial fibrillation in elective coronary artery bypass patients. Methods: A prospective study evaluated preoperative clinical and echocardiographic data in 192 patients who underwent elective coronary artery bypass from 2010 to 2012. Results: 18 (9.37%) patients developed postoperative atrial fibrillation. Compared to patients without postoperative atrial fibrillation, these 18 had significantly longer intensive care unit and hospital stays, they were significantly older (58.62 ± 10.02 vs. 53.22 ± 8.23 years; p < 0.02), with a larger left atrial volume (83.39 ± 8.31 vs. 55.47 ± 8.37 cm3, p < 0.001), longer atrial electromechanical interval (133.67 ± 8.15 vs. 98.05 ± 6.71 ms p < 0.0001), and lower tissue Doppler imaging systolic velocity wave amplitude (6.6 ± 1 vs. 9.4 ± 2.2 cm s−1; p < 0.001); they also had a higher prevalence of hypertension (61.11% vs. 38.5%; p < 0.04). Using 115 ms as the cutoff value of atrial electromechanical interval enabled us to detect patients who developed postoperative atrial fibrillation with 100% sensitivity, 77% specificity, 78% positive predictive value, and 100% negative predictive value. Conclusion: Older hypertensive patients are at higher risk of developing postoperative atrial fibrillation. Preoperative measurement of atrial electromechanical interval by tissue Doppler echocardiography is a useful predictor of postoperative atrial fibrillation in coronary artery bypass patients.