Risk factors of new atrial fibrillation after coronary artery bypass grafting_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Qi , DU Juan , SONG Yunhu , SUN Hansong , WANG Xin ,  ZHENG Zhe

Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, 100037, P.R.China;

Corresponding author：

ZHENG Zhe, Email: zhengzhe@fuwai.com

Keywords：

Cardiac surgery; atrial fibrillation; coronary artery bypass grafting; age

DOI：

10.7507/1007-4848.201906016

Video：

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Objective To analyze the risk factors of new-onset postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG).Methods From September 2011 to October 2013, 1 614 consecutive patients underwent elective coronary artery bypass grafting in Fuwai Hospital. There were 1 281 males and 333 females at average age of 60.3±8.4 years. Holter data recorded for 5 days after operation were collected and analyzed. The risk factors associated with POAF were assessed according to the baseline and intraoperative data, and the positive variables were stratified.Results A total of 314 patients (19.5%) developed new-onset POAF. The rate of POAF was elevating with the increase of age (P<0.001).Conclusion Age was an independent risk factor for POAF in patients undergoing elective CABG alone.

Citation： LI Qi, DU Juan, SONG Yunhu, SUN Hansong, WANG Xin, ZHENG Zhe. Risk factors of new atrial fibrillation after coronary artery bypass grafting. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(12): 1199-1203. doi: 10.7507/1007-4848.201906016 Copy

1.	LaPar DJ, Speir AM, Crosby IK, et al. Postoperative atrial fibrillation significantly increases mortality, hospital readmission, and hospital costs. Ann Thorac Surg, 2014, 98(2): 527-533.
2.	Arakawa M, Miyata H, Uchida N, et al. Postoperative atrial fibrillation after thoracic aortic surgery. Ann Thorac Surg, 2015, 99(1): 103-108.
3.	Augoustides JG, Szeto W, Ochroch EA, et al. Atrial fibrillation after aortic arch repair requiring deep hypothermic circulatory arrest: incidence, clinical outcome, and clinical predictors. J Cardiothorac Vasc Anesth, 2007, 21(3): 388-392.
4.	Tran DTT, Perry JJ, Dupuis JY, et al. Predicting new-onset postoperative atrial fibrillation in cardiac surgery patients. Cardiothorac Vasc Anesthe, 2015, 29(5): 1117-1126.
5.	Weidinger F, Schachner T, Bonaros N, et al. Predictors and consequences of postoperative atrial fibrillation following robotic totally endoscopic coronary bypass surgery. Eur J Cardiothorac Surg, 2014, 45(2): 318-322.
6.	Steinberg BA, Zhao Y, He X, et al. Management of postoperative atrial fibrillation and subsequent outcomes in contemporary patients undergoing cardiac surgery: insights from the Society of Thoracic Surgeons CAPS-Care Atrial Fibrillation Registry. Clin Cardiol, 2014, 37(1): 7-13.
7.	Mathew JP, Fontes ML, Tudor IC, et al. A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA, 2004, 291(14): 1720-1729.
8.	Zaman AG, Archbold RA, Helft G, et al. Atrial fibrillation after coronary artery bypass surgery: a model for preoperative risk stratification. Circulation, 2000, 101(12): 1403-1408.
9.	Melby SJ, George JF, Picone DJ, et al. A time-related parametric risk factor analysis for postoperative atrial fibrillation after heart surgery. J Thorac Cardiovasc Surg, 2015, 149(3): 886-892.
10.	Maisel WH, Rawn JD, Stevenson WG. Atrial fibrillation after cardiac surgery. Ann Intern Medi, 2001, 135(12): 1061-1073.
11.	Villareal RP, Hariharan R, Liu BC, et al. Postoperative atrial fibrillation and mortality after coronary artery bypass surgery. J Am Coll Cardiol, 2004, 43(5): 742-748.
12.	Gage BF, Waterman AD, Shannon W, et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA, 2001, 285(22): 2864-2870.
13.	Lip GY, Nieuwlaat R, Pisters R, et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro heart survey on atrial fibrillation. Chest, 2010, 137(2): 263-272.
14.	Chua SK, Shyu KG, Lu MJ, et al. Clinical utility of CHADS2 and CHA2DS2-VASc scoring systems for predicting postoperative atrial fibrillation after cardiac surgery. J Thorac Cardiovasc Surg, 2013, 146(4): 919-926.
15.	Gutsche JT, Patel PA, Cobey FC, et al. The year in cardiothoracic and vascular anesthesia: selected highlights from 2014. J Cardiothorac Vasc Anesth, 2015, 29(1): 1-7.
16.	Amat-Santos IJ, Rodés-Cabau J, Urena M, et al. Incidence, predictive factors, and prognostic value of new-onset atrial fibrillation following transcatheter aortic valve implantation. J Am Coll Cardiol, 2012, 59(2): 178-188.
17.	Ghadimi K, Patel PA, Gutsche JT, et al. Perioperative conduction disturbances after transcatheter aortic valve replacement. J Cardiothorac Vasc Anesth, 2013, 27(6): 1414-1420.
18.	Motloch LJ, Reda S, Rottlaender D, et al. Postprocedural atrial fibrillation after transcatheter aortic valve implantation versus surgical aortic valve replacement. Ann Thorac Surg, 2012, 93(1): 124-131.
19.	Wong JK, Lobato RL, Pinesett A, et al. P-wave characteristics on routine preoperative electrocardiogram improve prediction of new-onset postoperative atrial fibrillation in cardiac surgery. J Cardiothorac Vascr Anesth, 2014, 28(6): 1497-1504.

1. LaPar DJ, Speir AM, Crosby IK, et al. Postoperative atrial fibrillation significantly increases mortality, hospital readmission, and hospital costs. Ann Thorac Surg, 2014, 98(2): 527-533.
2. Arakawa M, Miyata H, Uchida N, et al. Postoperative atrial fibrillation after thoracic aortic surgery. Ann Thorac Surg, 2015, 99(1): 103-108.
3. Augoustides JG, Szeto W, Ochroch EA, et al. Atrial fibrillation after aortic arch repair requiring deep hypothermic circulatory arrest: incidence, clinical outcome, and clinical predictors. J Cardiothorac Vasc Anesth, 2007, 21(3): 388-392.
4. Tran DTT, Perry JJ, Dupuis JY, et al. Predicting new-onset postoperative atrial fibrillation in cardiac surgery patients. Cardiothorac Vasc Anesthe, 2015, 29(5): 1117-1126.
5. Weidinger F, Schachner T, Bonaros N, et al. Predictors and consequences of postoperative atrial fibrillation following robotic totally endoscopic coronary bypass surgery. Eur J Cardiothorac Surg, 2014, 45(2): 318-322.
6. Steinberg BA, Zhao Y, He X, et al. Management of postoperative atrial fibrillation and subsequent outcomes in contemporary patients undergoing cardiac surgery: insights from the Society of Thoracic Surgeons CAPS-Care Atrial Fibrillation Registry. Clin Cardiol, 2014, 37(1): 7-13.
7. Mathew JP, Fontes ML, Tudor IC, et al. A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA, 2004, 291(14): 1720-1729.
8. Zaman AG, Archbold RA, Helft G, et al. Atrial fibrillation after coronary artery bypass surgery: a model for preoperative risk stratification. Circulation, 2000, 101(12): 1403-1408.
9. Melby SJ, George JF, Picone DJ, et al. A time-related parametric risk factor analysis for postoperative atrial fibrillation after heart surgery. J Thorac Cardiovasc Surg, 2015, 149(3): 886-892.
10. Maisel WH, Rawn JD, Stevenson WG. Atrial fibrillation after cardiac surgery. Ann Intern Medi, 2001, 135(12): 1061-1073.
11. Villareal RP, Hariharan R, Liu BC, et al. Postoperative atrial fibrillation and mortality after coronary artery bypass surgery. J Am Coll Cardiol, 2004, 43(5): 742-748.
12. Gage BF, Waterman AD, Shannon W, et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA, 2001, 285(22): 2864-2870.
13. Lip GY, Nieuwlaat R, Pisters R, et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro heart survey on atrial fibrillation. Chest, 2010, 137(2): 263-272.
14. Chua SK, Shyu KG, Lu MJ, et al. Clinical utility of CHADS2 and CHA2DS2-VASc scoring systems for predicting postoperative atrial fibrillation after cardiac surgery. J Thorac Cardiovasc Surg, 2013, 146(4): 919-926.
15. Gutsche JT, Patel PA, Cobey FC, et al. The year in cardiothoracic and vascular anesthesia: selected highlights from 2014. J Cardiothorac Vasc Anesth, 2015, 29(1): 1-7.
16. Amat-Santos IJ, Rodés-Cabau J, Urena M, et al. Incidence, predictive factors, and prognostic value of new-onset atrial fibrillation following transcatheter aortic valve implantation. J Am Coll Cardiol, 2012, 59(2): 178-188.
17. Ghadimi K, Patel PA, Gutsche JT, et al. Perioperative conduction disturbances after transcatheter aortic valve replacement. J Cardiothorac Vasc Anesth, 2013, 27(6): 1414-1420.
18. Motloch LJ, Reda S, Rottlaender D, et al. Postprocedural atrial fibrillation after transcatheter aortic valve implantation versus surgical aortic valve replacement. Ann Thorac Surg, 2012, 93(1): 124-131.
19. Wong JK, Lobato RL, Pinesett A, et al. P-wave characteristics on routine preoperative electrocardiogram improve prediction of new-onset postoperative atrial fibrillation in cardiac surgery. J Cardiothorac Vascr Anesth, 2014, 28(6): 1497-1504.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Risk factors of new atrial fibrillation after coronary artery bypass grafting

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