Tachyarrhythmias and triggering factors for atrial fibrillation after coronary artery bypass operations

Ann Thorac Surg. 2000 Apr;69(4):1064-9. doi: 10.1016/s0003-4975(99)01431-9.

Abstract

Background: We evaluated the role of supraventricular arrhythmias and assessed clinical predictors of atrial fibrillation (AF) that developed after coronary artery bypass operations.

Methods: Eighty patients, with a mean age of 65.8 years, underwent 24-hour Holter monitoring preoperatively and for 4 consecutive days postoperatively, or until clinically documented AF, for analysis of the number of premature beats and tachyarrhythmias. Atrial areas and atrial peptides were measured preoperatively and postoperatively.

Results: Twenty-nine of 80 (36.3%) patients had postoperative AF. Preoperatively, the maximal supraventricular premature beats per minute were higher in the AF group (p = 0.02). The body mass index and total amount of cardioplegia were lower (p = 0.02 and p = 0.006, respectively), and withdrawal of beta-blockers postoperatively more frequent (p = 0.001) in the AF group, but atrial areas and atrial peptides did not differ.

Conclusions: Frequent supraventricular premature beats preoperatively may indicate a propensity for AF. A larger amount of cardioplegia during the cross-clamp period may reduce the risk of postoperative AF. Further studies are mandatory to clarify why patients with lower body mass index were more prone to AF.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Atrial Fibrillation / etiology*
  • Body Mass Index
  • Coronary Artery Bypass / adverse effects*
  • Coronary Disease / surgery
  • Electrocardiography, Ambulatory
  • Female
  • Humans
  • Male
  • Middle Aged
  • Tachycardia, Supraventricular / complications