Predictors Of Postoperative Atrial Fibrillation in Patients Undergoing Coronary Artery Bypass Grafting
mohamed ismail1, Ahmed El-Mahrouk2, Tamer Hamouda3, Hanan Radwan4, Ahmed Jamjoom5.
1Mansoura University, Egypt, Mansoura, Egypt, 2Tanta University, Egypt, Tanta, Egypt, 3Benha University, Egypt, Benha, Egypt, 4Zagazeg University, Egypt, Zagazeg, Egypt, 5king faisal specialist hospital, jeddah, ksa, Saudi Arabia.
OBJECTIVE: The reported incidence of AF after Coronary Artery Bypass Grafting (CABG) surgery varies from 20% to 40%, with the arrhythmia usually occurring between second and fourth postoperative days. Many perioperative factors have been suggested to increase the incidence of postoperative AF after conventional CABG. In this study we are trying to examine some of these risk factors as predictors for Post-operative AF in our patients. Aim of the work: In this study, our aim was to identify the perioperative predictors of AF in our patients who underwent CABG.
METHODS: Our Patients were divided into two groups; Group A included patients who did not develop PO AF (179 patients) and Group B patients who developed PO AF (96 patients). Perioperative Data, including gender, age, demographic variables and postoperative morbidity and mortality were extracted from the medical records.
RESULTS: This retrospective cohort study was conducted on 275 consecutive adult patients underwent CABG with or without valve surgery, in King Faisal Specialist Hospital and Research Center in Jeddah, Saudi Arabia. The mean age for patients with PO AF was 63 years (P=.0001). Eight-eight patients [52.7%] were diabetics in group A and 65 patients (74.4%) in group B (P=.0001). Patients who developed POAF had a lower ejection fraction (45.7%) (P=.0001), diastolic dysfunction (P=.0001), Larger Left atrial volume (P=.0001). Bleeding requiring re-opening for exploration and Postoperative shock were identified as significant predictors for POAF. Multivariate logistic regression (odds ratio, ±95% CI, P value) was performed to identify the effect of age, preoperative heart rate, ejection fraction, postoperative bleeding, Shock, ventilator time, Sensitivity was 89.5%, specificity was 94.6%, positive predictive value was 89.5%, and negative predictive value was 94.6%.
CONCLUSIONS: Age, Diabetes mellitus, LA volume, and Low Ejection fraction were found to be significant predictors for postoperative Atrial Fibrillation in patients undergoing coronary artery Bypass Grafting.
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