Perioperative Risk Factors Predisposing to Atrial Fibrillation After CABG Surgery

Authors

  • Alaa Omar, MD Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University, Giza, Egypt
  • Ehab El-Shihy, MD Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University, Giza, Egypt
  • Mahmoud Singer, MD Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University, Giza, Egypt
  • David Zarif, MSSC Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University, Giza, Egypt
  • Omar Dawoud, MD Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University, Giza, Egypt

DOI:

https://doi.org/10.1532/hsf.3759

Keywords:

Atrial Fibrillation, CABG

Abstract

Objectives: To detect perioperative risk factors for atrial fibrillation (AF) after coronary artery bypass graft (CABG) and to assess the impact of AF on outcome and postoperative complications.

Methods: We undertook a prospective observational study of 1000 consecutive patients who underwent isolated CABG in Cairo University hospitals and other centers from March 2019 to November 2020. Patients were subsequently divided into 2 groups depending on the occurrence of postoperative AF. Preoperative, intraoperative, and postoperative risk factors were recorded for all patients, as well as postoperative mortality, complications, and hospital and intensive care unit (ICU) lengths of stay.

Results: Postoperative atrial fibrillation (POAF) occurred in 78 patients (7.8%), with significant risk factors of age (P = .001), low ejection fraction (P = .001), absence of preoperative beta-blocker use (P = .001), and presence of right coronary artery lesion (P = .003). The intraoperative significant risk factor was the absence of total coronary revascularization (P = .001). Postoperative significant risk factors were electrolyte imbalance (P = .001) and postoperative inotropes (P = .02). Patients with postoperative AF had increased risk of mortality (P = .001) and longer ICU (P = .001) and hospital (P = .001) stays.

Conclusion: The risk of POAF can be decreased by modifying perioperative adjustable risk factors, namely routinely using preoperative beta-blockers (unless contraindicated), achieving total coronary revascularization, avoiding postoperative electrolyte imbalance, and avoiding unnecessary use of inotropic support.

References

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Published

2021-04-27

How to Cite

omar, alaa, ehab m elshihy, mahmoud singer, david Zarif, & omar dawoud. (2021). Perioperative Risk Factors Predisposing to Atrial Fibrillation After CABG Surgery. The Heart Surgery Forum, 24(2), E402-E406. https://doi.org/10.1532/hsf.3759

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Section

Articles