Atrial Fibrillation After Coronary Artery Bypass Surgery

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Abstract
Background—Atrial fibrillation (AF) occurs in 20% to 40% of patients after CABG. Identification of patients vulnerable for arrhythmia will allow targeting of those most likely to benefit from prophylactic therapy. The aim of the present study was to evaluate accuracy of a prospectively defined signal-averaged P-wave duration (SAPD) cutoff and additional preoperative characteristics for the prediction of AF after CABG. Methods and Results—Patients undergoing elective isolated CABG were recruited to the present prospective study. SAPD was recorded in all patients. Filtered signals from 3 orthogonal leads were combined in a vector analysis, and total SAPD was measured preoperatively. Postoperative in-hospital AF occurred in 92 (28.2%) of 326 patients. Patients who developed AF were older (65.9 versus 61.7 years of age; PP155 ms (odds ratio, 5.37; 95% CI, 3.10 to 9.30; PPP155 ms predicted AF with positive and negative predictive accuracy of 49% and 84%, respectively. Conclusions—A combination of prolonged SAPD, advanced age, and male sex identifies patients at high risk for development of AF after CABG.