THE VALUE OF ATRIAL ELECTROMECHANICAL DELAY IN PREDICTING ATRIAL
FIBRILLATION DEVELOPMENT AFTER CORONARY ARTERY BYPASS SURGERY
Abstract
Objective: Predicting postoperative atrial fibrillation (PoAF) in the
preoperative period will provide a serious advantage in preventing the
morbidity and mortality associated with this arrhythmia and in planning
the treatment. In this study, we investigated the value of atrial
electromechanical delay (AEMD) in predicting the development of PoAF.
Methods: A total of 93 patients who underwent isolated coronary artery
bypass grafting (CABG) operation were included in this prospective
study. Patients’ demographic characteristics, laboratory parameters,
echocardiographic data, and AEMD durations that could be measured by the
co-use of electrocardiography and echocardiography were recorded. The
patients at sinus rhythm during the postoperative period were identified
as “Group 1”, and those who developed PoAF were identified as “Group
2”. Results: PoAF incidence was 26.88% (n=25). Left ventricle (LV)
lateral AEMD, LV medial AEMD, right ventricle lateral AEMD, and left
atrium (LA) lateral AEMD durations of Group 2 were significantly higher
than Group 1 (p<0.001, p=0.004, p=0.004, p<0.001;
respectively). In Univariate Logistic Regression Analysis, the age,
hypertension, LA maximum volume, LA lateral AEMD and pulmonary artery
pressure were significantly associated with PoAF development (p=0.01,
p=0.004, p=0.004, p=0.001, p=0.01; respectively). However, only LA
lateral AEMD was found as an independent predictive factor for the
development of PoAF in the Multivariate Logistic Regression Analysis
(OR:1.03, 95% CI:1,001-1.06, p=0.04). AUC was 0.741 for LA lateral AEMD
in ROC Curve Analysis (95% CI:0.633-0.849, p<0.001).
Conclusions: The development of PoAF can be predicted by AEMD durations
measured in the preoperative period in patients undergoing isolated
CABG.