[Incidence and predictors of atrial fibrillation after coronary artery bypass grafting in the Negev--are we different from the rest of the world?].Harefuah. 2008 Apr; 147(4):299-304, 375.H
Atrial fibrillation (AF) remains a common problem after coronary artery bypass grafting (CABG). AF increases the risk for stroke and is associated with increased length of hospitalization and mortality.
This study aimed to determine incidence, timing and predictors of post CABG AF in a prospectively evaluated cohort of patients undergoing CABG in the Negev.
Preoperative clinical data, intraoperative, intensive care and postoperative events including AF episodes were prospectively evaluated in 156 consecutive patients undergoing CABG during a nine month period ending on July 2003.
Mean age was 64.9 years (SD = 9.7, range 41 - 84 years); 76.3% (119) were male. The in-hospital mortality was 1.2% (2 patients). The incidence of AF was 32.1% (50), with 40% of the AF episodes occurring on the second postoperative day (range 1-6 days). Univariate analyses identified the following variables as risk factors for AF: female gender, older age, ethnic origin, BMI > 30, hypertension, dyslipidemia, pre CABG nitrate, Ca blockers and furosemide treatment, left atrial diameter, renal failure and post CABG respiratory complications (p <0.05). By multivariate analysis, three variables were identified as independent predictors: BMI>30 (odds ratio 2.4; 95% CI 1.2-4.8); Sephardic Jews (OR 11.2; CI 1.0-114); enlarged left atrium (OR 4.6; CI 1.5-14.1).
Consistent with previous studies, enlarged left atrium was a predictor of post CABG AF. In addition ethnic origin (Sephardic Jews) and BMI> 30 were also found to be important predictors of post CABG AF. In comparison with other studies, we not found moderate differences in outcomes and mortality in population that underwent CABG in the Negev in comparison to studies of the world.