Incidence, Predictors, and Prognostic Impact of New-onset Atrial Fibrillation After Isolated Primary Coronary Artery Bypass Grafting

Abstract

Background: New-onset atrial fibrillation (NOAF) after coronary artery bypass grafting (CABG) is associated with considerable morbidity and mortality. The objectives of this study were to estimate the incidence and predictors of NOAF after isolated primary CABG and evaluate its prognostic impact on the hospital outcomes of surgery.

Methods: This study included 154 consecutive patients who underwent isolated primary CABG between October 2021 and February 2022. Patients were divided into two groups; Group 1 included patients with NOAF, and Group 2 had patients without NOAF.

Results: NOAF occurred in 29 patients (18.8%). NOAF patients were significantly older (52.13± 6.30 vs. 55.45± 7.47 years; p =0.028), with more prevalence of diabetes mellitus but did not reach a significant level (62.1% vs. 44.8%; p = 0.094) and had a greater preoperative white blood cells count (WBCs) (8.87± 2.95 vs. 8.0± 2.17 /mm3; p = 0.071). Preoperative creatinine clearance (137.58± 53.94 vs. 114.94± 39.18 ml/min; p = 0.04), postoperative ischemic ECG changes (55.2% vs. 30%; p = 0.004), perioperative myocardial infarction (31% vs. 15.2%; p= 0.046), postoperative CK-MB (84.83± 81.26 vs. 64.76±46.58 units; p= 0.077), hemodynamic instability (72.4% vs. 41.6%; p= 0.003), and postoperative significant ECG changes (34.5% vs. 17.6%; p= 0.044) were greater in patients with NOAF. Age, preoperative creatinine clearance, preoperative WBC, and DM were associated with NOAF in the univariable analysis. None were found to be predictors of NOAF in the multivariable analysis.

Conclusions: NOAF after isolated primary CABG is common. Advanced age, renal function, hemodynamic instability, and perioperative myocardial infarction might be associated with NOAF