Factors contributing to the development of postoperative atrial fibrillation in patients who have undergone coronary artery bypass grafting
Abstract
Background. Postoperative atrial fibrillation (POAF) is a common complication in patients undergoing coronary artery bypass grafting (CABG), which significantly affects recovery and increases the risk of adverse outcomes. The factors contributing to POAF development remain an area of ongoing research, with many studies investigating clinical, anamnestic, and procedural predictors.
Materials and methods. This study evaluated 208 patients with coronary artery disease who were scheduled for off-pump coronary artery bypass grafting (OPCABG). The average age of participants was 56.6 ± 18.4 years, including 29 women and 179 men. Holter ECG monitoring was performed on all patients 5 days and 24 hours before surgery to assess preoperative cardiac rhythms.
Results. Postoperative atrial fibrillation occurred in 41 patients (19.7%). Hypertension, obesity, and diabetes mellitus (DM) were found to be significantly more prevalent in the POAF group compared to the non-POAF group (p<0.001). Additionally, clinical parameters, including Holter ECG monitoring, revealed that myocardial fibrosis plays a major role in the development of POAF, particularly in patients with these comorbid conditions.
Conclusion. The study indicates that postoperative atrial fibrillation occurs in 19% of OPCABG patients, with key risk factors such as hypertension, obesity, and diabetes mellitus contributing significantly to its development. The findings underscore the importance of early detection and management of these factors to reduce the incidence of POAF.
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List of references
Mitchell L.B., Incidence, timing and outcome of atrial tachyarrhythmias after cardiac surgery, Atrial fibrillation after cardiac surgery, Kluwer Academic Publishers, , 2000, 37–50.
Alexin A.A., Postoperative atrial fibrillation in thoracic surgery, Vestnik anesteziologii i reanimatologii, 2014, 02, 71–78.
Rostagno C., Blanzola C., Pinelli F., Atrial fibrillation after isolated coronary surgery. Incidence, long term effects and relation with operative technique, Heart Lung Vessel, 2014, 6, 171–179.
Chen P.S., Chen L.S., Fishbein M.C., Role of the autonomic nervous system in atrial fibrillation: pathophysiology and therapy, Circulation Research, 2014, 114, 1500–1515.
Steinberg J.S., Postoperative atrial fibrillation: a billion-dollar problem, Journal of the American College of Cardiology, 2004, 43, 1001–1003.
Echahidi N., Pibarot P., O’Hara G., Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery, Journal of the American College of Cardiology, 2008, 51, 793–801.
Maesen B., Nijs J., Maessen J., Post-operative atrial fibrillation: a maze of mechanisms, Europace, 2012, 14, 159–174.
Alameddine A.K., Visintainer P., Alimov V.K., Blood transfusion and the risk of atrial fibrillation after cardiac surgery, Journal of Cardiac Surgery, 2014, 29, 593–599.
Ajam F., Patel S., Alrefaee A., Cardiac Arrhythmias in Patients with End Stage Renal Disease (ESRD) on Hemodialysis; Recent Update and Brief Literature Review, American Journal of Internal Medicine, 2019, 7, 01, 22–26.
Madjid M., Safavi P.Naeini, Solomon S., Vardeny O., Potential Effects of Coronaviruses on the Cardiovascular System, JAMA Cardiology, 2020, 5, 07, 831–840, 10.1001/jamacardio.2020.1286.
Copyright (c) 2025 О.О. Жаббаров, Г.У. Муллабаева , И.М. Шарипов , Х.Г. Фозилов (Автор)
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