Atrial Fibrillation After Surgical Myocardial Revascularization

pp 249-254

Abstract

Background

Atrial fibrillation (AF) is a frequent complication of coronary artery bypass graft surgery (CABG) that leads to increased costs and morbidity.

The purpose of this study was to identify etiologi-cal risk factors associated with AF, complicating postoperative course of CABG, and to asses whether it may delay hospital discharge.

Material and methods

Three thousand and eight consecutive patients undergoing isolated CABG surgery between July 1992 and March 1996 were included in the study. Twenty-seven preoperative and postoperative epidemiological variables were considered in order to identify the possible causes of AF. Statistical analysis were performed using Mann-Whitney and chi square tests by univariate and multiple logistic regression by multivariate analysis.

Results

Mean age of patients was 61.4 years, AF incidence was 15.9%. Univariate analysis showed that age (p <0.0001), renal failure (p < 0.0008), diabetes (p < 0.074), neurological history (p < 0.004), peripheral vasculardisease (p < 0.01), severe respiratory disease (p <0.005), severe left ventricular dysfunction (p < 0.0001), urgent-emergent surgery (p < 0.022), cardiopulmonary bypass time (p < 0.012) and heart failure after surgery (p < 0.0001) were predictors ofAE In the logistic regression model, age over 65 years (p < 0.0001) and severe left ventricular dysfunction (p < 0.0001) were found to be independent predictors of AF Length of in hospital stay increased by 10% (p = 0.001).

Conclusions

1) Patients older than 65 years with left ventricular dysfunction and associated pathology have greater risk to develop AF during the postoperative of CAB G. 2) Prolonged cardiopulmonary bypass time and postoperative heart failure are related to AF on set. 3) AF delayed discharge and increased the surgical expenses.