| Abstrakt: |
Objectives To determine the incidence of atrial fibrillation (AF) after conventional and off-pump coronary artery bypass grafting (CABG), and identify its predictors. Methods 70 patients, all male, underwent isolated CABG. Patients with history of AF, concomitant valve pathology, severe heart failure, thyroid dysfunction were excluded. Pre- and postoperative examination included all conventional noninvasive and invasive diagnostic procedures, among them measurement of signal-averaged P-wave duration. Results Overall occurrence of AF was 20%, following on-pump CABG 21%, off-pump CABG 19% (p=0.45). Multivariate logistic regression analysis identified following independent predictors of postoperative AF: increasing age (β=1.9), longer history of coronary artery disease (CAD) (β=1.7), longer signal-averaged P-wave duration (SAPD) (β=1.8), left atrium enlargement (β=1.4), longer cardiopulmonary bypass (CPB) and aortic cross-clamping times (β=1.6), need for intraoperative intra-aortic balloon pump (β=1.7), ventilation time over 24 hours and pneumonias (β=1.4). Conclusions Increasing age, longer history of CAD and SAPD were most powerful preoperative predictors of postoperative AF. Insignificant difference in the incidence of AF after conventional and beating heart CABG allows assuming that CPB is not main trigger in pathophysiology of this arrhythmia. [ABSTRACT FROM PUBLISHER] |
