• Asian Cardiovasc Thorac Ann · Jul 2014

    Clinical and echocardiographic predicators of postoperative atrial fibrillation.

    • Mohamed Ahmed Elawady and Mohamed Bashandy.
    • Saud Al-Babtain Cardiac Center, Dammam, Saudi Arabia Cardiothoracic Surgery Department, Banha Faculty of Medicine, Banha University, Egypt mohamedawady@yahoo.com.
    • Asian Cardiovasc Thorac Ann. 2014 Jul 1; 22 (6): 655-9.

    BackgroundPostoperative atrial fibrillation is the most common arrhythmia after coronary artery bypass grafting, with a reported incidence of 10% to 60%. Preoperative clinical and echocardiographic data, especially the atrial electromechanical interval, predict postoperative atrial fibrillation in elective coronary artery bypass patients.MethodsA prospective study evaluated preoperative clinical and echocardiographic data in 192 patients who underwent elective coronary artery bypass from 2010 to 2012.Results18 (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 cm(3), 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.ConclusionOlder 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.© The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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