Premium
Increased Dispersion of Refractoriness in Patients with Atrial Fibrillation in the Early Postoperative Period after Coronary Artery Bypass Grafting
Author(s) -
SOYLU MUSTAFA,
DEMIR AHMET DURAN,
ÖZDEMIR ÖZCAN,
SOYLU ÖZER,
TOPALOĞLU SERKAN,
KUNT AYŞEGÜL,
SASMAZ ALI,
KORKMAZ ŞULE,
TAŞDEMIR OĞUZ
Publication year - 2003
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1046/j.1540-8167.2003.02218.x
Subject(s) - medicine , odds ratio , confidence interval , atrial fibrillation , cardiology , refractory period , anesthesia
Preoperative EP Characteristics of Post‐CABG AF. Introduction: Increased atrial effective refractory period (AERP) dispersion is well correlated with vulnerability to atrial fibrillation (AF). However, the preoperative electrophysiologic characteristics of atrial abnormalities that may play an important role in the development of AF postoperatively in patients with coronary artery bypass grafting (CABG) have not been investigated in detail.Methods and Results: Fifty‐six consecutive patients who underwent CABG were enrolled in this study. Eighteen patients (14 men and 4 women; meanage 57.7 ± 5.2 years) with AF in the early postoperative period and 38 patients (28 men and 10 women; meanage 56.3 ± 6.4 years) without AF were compared with regard to preoperative clinical, echocardiographic, angiographic, and electrophysiologic parameters. Preoperative PA interval and AERP dispersion values were higher(P < 0.05)in patients who developed AF in the early postoperative period. PA interval (P < 0.05, odds ratio = 1.64, 95% confidence interval 1.17–2.30), AERP in the high right atrium (AERP HRA ;P < 0.05, odds ratio = 0.94, 95% confidence interval 0.91–0.97), AERP in the right posterolateral atrium (AERP RPL ;P < 0.05, odds ratio = 0.79, 95% confidence interval 0.63–0.98), AERP in the distal coronary sinus (AERP DCS ;P < 0.05, odds ratio = 0.84, 95% confidence interval 0.74–1.02), and AERP dispersion (P < 0.001, odds ratio = 1.29, 95% confidence interval 1.12–1.47) were independently related to post‐CABG AF in univariate analysis. Increases in preoperative PA interval and AERP dispersion were found to be associated with a high risk for development of post‐CABG AF.Conclusion: AERP dispersion is a suitable electrophysiologic indicator for atrial vulnerability. The presence of increased preoperative AERP dispersion and PA interval may indicate patients at high risk for development of AF in the early postoperative period after coronary artery bypass grafting.