Predictive value of total atrial conduction time measured with tissue Doppler imaging for postoperative atrial fibrillation after coronary artery bypass surgery

Objective

Postoperative atrial fibrillation (POAF) complicating coronary artery bypass grafting surgery (CABG) increases morbidity and stroke risk. Total atrial conduction time (PA-TDI duration) has been identified as an independent predictor of new-onset atrial fibrillation (AF). We aimed to assess whether PA-TDI duration is a predictor of AF after CABG.

Methods

In 128 patients who had undergone CABG, preoperative clinical and echocardiographic data were compared between patients with and without POAF. The PA-TDI duration was assessed by measuring the time interval between the beginning of the P wave on the surface ECG and point of the peak A wave on TDI from left atrium (LA) lateral wall just over the mitral annulus.

Results

Patients with POAF (38/128, 29.6 %) were older (68.1?±?11.1 vs. 59.3?±?10.2 years; p?<?0.001), had higher LA maximum volume, had prolonged PA-TDI duration, and had lower ejection fraction compared with patients without POAF. PA-TDI duration was found to be significantly increased in POAF group (134.3?±?19.7 vs. 112.5?±?17.7 ms; p?=?0.01). On multivariate analysis, age (95 % CI?=?1.03–1.09; p?=?0.003), LA maximum volume (95 % CI?=?1.01–1.06; p?=?0.03), and prolonged PA-TDI duration (95 % CI, 1.02–1.05; p?=?0.001) were found to be the independent risk factors of POAF.

Conclusions

In this study, LA maximum volume and PA-TDI duration were found to be the independent predictors of the development of POAF after CABG. Echocardiographic predictors of left atrial electromechanical dysfunction may be useful in risk stratifying of patients in terms of POAF development after CABG.