The role of surface ECG and transthoracic echocardiography for predicting postoperative atrial fibrillation after coronary artery bypass surgery

Objective:Toevaluatetherolesofsurfaceelectrocardiogram (ECG) and transthoracic echocardiography (ECHO) for prediction of atrial fibrillation (AF) after coronary artery bypass grafting (CABG). Methods: This study was conducted from 2002-2004 at the Cardiovascular Department of Hacettepe University, Ankara, Turkey. Seventy consecutive patients were enrolled in this study that underwent elective CABG. A 12-lead ECG was recorded one day before cardiac surgery and was repeated during the 5 days after CABG. P-wave dispersion (PWD) was defined as the difference between maximum and minimum P-wave duration. Differences in P-wave duration were compared between the pre- and postoperative 12-lead ECG measurements. Results: Postoperative AF developed in 17 (24%) cases of 70 patients. The PWD was found to be significantly higher in patients with AF preoperatively (60±19 versus 47±13, p=0.003), postoperative first day (56±12 versus 44±11, p 0.002) and fifth day (51±29 versus 41±11, p 0.001). Patients with AF were significantly older, the mean age of the AF group was (68±7 years) and of the sinus rhythm (SR) group was (59±10 years) (p 0.001).The AF group had left ventricular systolic dysfunction (56±13% versus 56±8%, p=0.042, preoperatively; 49±8% versus 60±10%, p=0.001, postoperatively) and a larger left atrium (46±5 versus 39±5 mm, p 0.001, preoperatively and 44±7 versus 39±5 mm, p=0.046, postoperatively) than the SR group. Conclusion: This prospective study demonstrated that PWD on surface ECG and additional echocardiographic parameters are simple and reliable indexes to predict the development of AF after CABG.