A total of 249 patients undergoing isolated coronary revascularization were studied for the occurrence of postoperative atrial fibrillation(AF). Possible associations of this arrhythmia with various preoperative, intraoperative and postoperative
factors
were studied by univariate and multivariate analysis. The overall indidence of postoperative AF was 15%, with the median time occurrence of 48 hours(mean time : 59.1±56.9 hours)after arrival to the intensive care unit. Cardiac index decreased
significantly after occurrence of AF(p=0.001). There were no in-hospital complications in those patients with AF. Univariate studies indicated preoperative ejection fraciton(EF), triglyceride level, postoperative peak DKMB isoenzyme and atrial
pacing to
be the dominant factor promoting postoperative AF, with an increasing prealence in lower EF(p=0.025), triglyceride(p=0.006) and peak CKMB isoenzyme(p=0.002), and patients with atrial pacing(p=0.001). Hospital stay(p=0.001)and late
mortality(p=0.003)were
significantly increased in patients with postoperative AF. Multivariate analysis showed that body weight and postoperative atrial pacing to be the dominant factor promoting postoperative AF, with an increasing prevalence in overweight
patients(p=0.011)and patients with atrial pacing(p=0.001). Both univariate and multivariate analysis showed that the age was not a significant factor but tended to promote postoperative AF respectively(p=0.053, 0.064). After 30.1±15.4months
gfollow-up,
those patients with AF had sinus rhythm.
We think that we nust try to prevent postoperative AF after ccoronary artery bypass grafting because of its deleterious hemodynamic effect, prolonged hospial stay, and increased late mortality.
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