Left atrial functional measurements utility in predicting long-term risk
of atrial fibrillation after isolated CABG
Abstract
Abstract Background: Atrial fibrillation (AF) is the
most common cardiac arrhythmia following coronary artery bypass grafting
(CABG). We hypothesized that measures of left atrial (LA) function would
be useful in predicting AF in patients undergoing CABG. Methods
and Results In the study, 611 patients were included after CABG. All
patients had echocardiograms performed preoperatively and LA functional
measurements were assessed. These measurements were LA maximum volume
index (LAVmax), LA minimum volume index (LAVmin) and LA emptying
fraction (LAEF). The endpoint was AF occurring >14 days
after surgery. During the follow-up period of a median of 3.7 years, 52
(9%) developed AF. The mean age was 67 years, 84% were male and the
average left ventricle ejection fraction was 50 %. No differences were
observed between the patients developing AF and those who did not
develop AF. No functional LA measurements were significant predictors of
AF in the whole CABG population. However, in patients with normal-sized
LA (n=532, events: 49), both LAEF and LAVmin were univariable predictors
of AF. When the functional measurements were adjusted for the CHADS
2 score, both LAVmin (HR=1.07 (1.01-1.13), p=0.014 ) and
LAEF (HR: 1.02 (1.00-1.03, p= 0.023)), remained significant predictors.
Conclusion No echocardiographic measurements were significant
predictors of AF after CABG. In patients with a normal LA size, LAVmin
as well as LAEF were significant predictors of AF. Keywords:
atrial fibrillation; cardiac surgery; left atrium; echocardiography