Prognostic factors of atrial fibrillation following coronary artery bypass graft surgery

• Published in: General thoracic and cardiovascular surgery Vol. 65; no. 10; pp. 566 - 574
• Main Authors: Kievišas, Mantas, Keturakis, Vytenis, Vaitiekūnas, Egidijus, Dambrauskas, Lukas, Jankauskienė, Loreta, Kinduris, Šarūnas
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01-10-2017; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Anesthesia; Antiarrhythmics; Aspirin; Atrial Fibrillation - epidemiology; Atrial Fibrillation - etiology; Body mass index; Cardiac arrhythmia; Cardiac Surgery; Cardiology; Cardioversion; Chronic obstructive pulmonary disease; Contraindications; Coronary Artery Bypass - adverse effects; Coronary vessels; Ejection fraction; Female; Heart failure; Heart rate; Heart surgery; Hemodynamics; Hospitals; Humans; Hypokalemia; Incidence; Intensive care; Lithuania - epidemiology; Male; Medicine; Medicine & Public Health; Middle Aged; Myocardial Ischemia - surgery; Original Article; Patients; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Potassium; Prognosis; Prospective Studies; Standard deviation; Statistical analysis; Surgical Oncology; Thoracic Surgery; Multivariate analysis; Atrial fibrillation; Coronary artery bypass graft surgery; Predictors
• ISSN: 1863-6705; 1863-6713
• DOI: 10.1007/s11748-017-0797-6

Objective
Postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery. To prevent this complication, routine pharmacological prophylactic drugs could be administered. Our study aimed to analyze the various perioperative factors associated with the development of POAF after coronary artery bypass graft (CABG) surgery.
Methods
This prospective study included 617 patients, who received CABG surgery in the year 2014.
Results
There were 429 (69.5%) male and 188 (30.5%) female patients. Mean patient age was 67.2 (9.4) years, and 365 patients (59.2%) were more than 65 years. Incidence of POAF was 24.1% (
N
 = 149). Multivariable analysis showed that independent predictors of POAF after CABG surgery were: age >65 (
P
  = 0.008; OR 2.089; 95% CI 1.208–3.613), AF in the past (
P
 < 0.001; OR 10.838; 95% CI 5.28–22.247), preoperative hypertrophy or dilation of left atrium (
P
 = 0.002; OR 4.996; 95% CI 1.823–13.691), CABG surgery using 4 or more bypass grafts (
P
 = 0.042; OR 1.669; 95% CI 0.972–2.866), preoperative hypokalemia (
P
 = 0.001; OR 3.317; 95% CI 1.678–6.559), >trivial mitral (
P
 = 0.024; OR 7.556; 95% CI 0.964–20.376), and aortic (
P
 = 0.009; OR 1.937; 95% CI 1.178–3.187) valve regurgitation.
Conclusions
The profile of patients affected by POAF was considerably different with regard to the demographics, preoperative heart condition, history of previous heart rhythm disorders, and operative data. The most important independent factors that predicted POAF after CABG surgery were associated with structural heart defects, advanced age, history of previous AF, and preoperative hypokalemia.