Analysis Of Predictors Of Atrial Fibrillation Early Following Coronary Artery Bypass Grafting Surgery

Objective: To analyse the clinical predictors of atrial fibrillation(Af) early after coronary artery bypass grafting (CABG), and provide evidence for prevention and treatment.Methods: 101 consecutive patients underwent isolated CABG procedure from Mar. 1998 to Oct. 2002 were retrospective analyzed. The patients were grouped according to whether Af appeared after CABG. Factors including age, preoperative Af or not, history of myocardial infarction, high blood pressure, diabetes mellitus, left ventricular ejection fraction(LVEF), stenosis surpass 50 percent in proximal and median segments of right coronary artery; intraoperative factors such as cardiopulmonary bypass(CPB) time, aorticclamping time and operative methods(off-pump coronary artery bypass grafting or not); postoperative factors including mechanical ventilation time, total volume of chest drainage 3 days after operation, and effect of medication after operation( blockade, Ca2+ blockage, adrenoceptor agonists and digitalis) were analyzed to identify the predictors for postoperative Af. Independent-Samples T Test and Chi-Square Test were used for statistic analysis.Results: The overall incidence of postoperative Af was 21.8%(22/101). 19 (77.3%) appeared during 1-3 days after operation, 2 in 4-7 days, and 1 more than 7 days. The average age, CPB and aortic clamping time, mechanical ventilation time, total volume of chest drainage 3 days after operation of Af group were more than those of non-Af group (P<0.05); Incidence of Af in patients with stenosis surpass 50 percent in proximal and median segments of RCA is 81.8%. 23 patients received OPCAB, 3(13.0%) appeared Af after operation, while 19(24.4%) of 78 who received CCABG appeared Af after operation(P<0.05); 3 preoperative Af patients maintain Af after operation. There were no statistic significances between the two groups as for gender, history of myocardial infarction, high blood pressure, diabetes mellitus, LVEF, or whether digitalis was used.Conclusions:1. Incidence of Af after CABG is 21.8%, 77.3% appeared during the 1-3days after operation.2. Many factors associated with Af after CABG, some important ones were age, CPB and aortic clamping time, mechanical ventilation time, total volume of chest drainage 3 days after operation.3. Stenosis surpass 50 percent in proximal and median segments of RCA is an independent risk factor.4. Preoperative Af patients maintain Af after CABG.5. Incidence of Af in OPC AB is lower than that in CC ABG.