TY - JOUR
T1 - Predictors of atrial fibrillation after off-pump coronary artery bypass graft surgery
AU - Zangrillo, Alberto
AU - Landoni, Giovanni
AU - Sparicio, Donatella
AU - Benussi, Stefano
AU - Aletti, Giacomo
AU - Pappalardo, Federico
AU - Fracasso, Giulia
AU - Fano, Greta
AU - Crescenzi, Giuseppe
PY - 2004/12
Y1 - 2004/12
N2 - Objective: Atrial fibrillation is the most common complication after coronary artery bypass graft surgery. This arrhythmia may lead to hemodynamic compromise, prolonged hospitalization, and increased risk for cerebral thromboembolism. Older age is the only variable consistently associated with the development of postoperative atrial fibrillation; however, no strong predictive model exists. The purpose of this study was to identify perioperative characteristics associated with new-onset atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting. Design: Prospective, observational. Setting: University tertiary care hospital. Participants: One hundred sixty consecutive patients undergoing off-pump coronary artery bypass grafting. Interventions: None. Measurements and Main Results: Incidence of postoperative atrial fibrillation was the major outcome. Atrial fibrillation occurred in 33 patients (20.6%). Multivariate analysis identified reintervention (odds ratio 26.8), revascularization of the ramus medianus (odds ratio 3.9), and age (odds ratio 1.069 per year) as the only independent predictors of postoperative atrial fibrillation. All patients were in sinus rhythm at hospital discharge. One hospital death was noted. Conclusions: Despite the less invasive approach, the incidence of postoperative atrial fibrillation is high after off-pump coronary artery bypass grafting. Older age, grafting of the ramus medianus, and a redo operation were predictors of new-onset postoperative atrial fibrillation. It is possible that left atrial stretching with heart dislocation during revascularization of the lateral wall could lead to postoperative atrial fibrillation.
AB - Objective: Atrial fibrillation is the most common complication after coronary artery bypass graft surgery. This arrhythmia may lead to hemodynamic compromise, prolonged hospitalization, and increased risk for cerebral thromboembolism. Older age is the only variable consistently associated with the development of postoperative atrial fibrillation; however, no strong predictive model exists. The purpose of this study was to identify perioperative characteristics associated with new-onset atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting. Design: Prospective, observational. Setting: University tertiary care hospital. Participants: One hundred sixty consecutive patients undergoing off-pump coronary artery bypass grafting. Interventions: None. Measurements and Main Results: Incidence of postoperative atrial fibrillation was the major outcome. Atrial fibrillation occurred in 33 patients (20.6%). Multivariate analysis identified reintervention (odds ratio 26.8), revascularization of the ramus medianus (odds ratio 3.9), and age (odds ratio 1.069 per year) as the only independent predictors of postoperative atrial fibrillation. All patients were in sinus rhythm at hospital discharge. One hospital death was noted. Conclusions: Despite the less invasive approach, the incidence of postoperative atrial fibrillation is high after off-pump coronary artery bypass grafting. Older age, grafting of the ramus medianus, and a redo operation were predictors of new-onset postoperative atrial fibrillation. It is possible that left atrial stretching with heart dislocation during revascularization of the lateral wall could lead to postoperative atrial fibrillation.
KW - atrial fibrillation
KW - coronary artery bypass grafting
KW - off-pump surgery
KW - OPCAB
KW - postoperative arrhythmias
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U2 - 10.1053/j.jvca.2004.08.005
DO - 10.1053/j.jvca.2004.08.005
M3 - Article
C2 - 15650977
AN - SCOPUS:11844272585
VL - 18
SP - 704
EP - 708
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
IS - 6
ER -