European Journal of Molecular & Clinical Medicine

Abstract

Background: Postoperative atrial fibrillation (POAF) is a common and potentially morbid
complication following cardiac surgery. It was reported to be associated with greater inhospital
mortality; prolonged hospital stays. In addition, the long-term survival was worse in
patients who developed POAF. Patients who develop POAF incur additional hospital
treatment cost and 2-to-4-fold increased risk of major adverse cardiac events.
Objective: To determine the possible predictors of POAF after coronary artery bypass
surgery and its impact on outcome.
Methods: Two hundred patients were enrolled; they were divided into 2 groups; Group I (n =
100 patients) developed POAF and group II (n = 100 patients) did not developed POAF. All
patients were subjected to history, examination, ECG, echocardiography, laboratory
investigation as CBC, coagulation profile, kidney function tests, liver enzymes and high
sensitivity troponin and coronary angiography to assess severity of coronary artery disease by
SYNTAX score.
Results: POAF score which contain 9 variables: Age >60 y, Smoking, COPD, CP bypass time
(min) >86.5, Vent. Time <23.5, PLR >113.4, LVEF <53.5, RV function by TAPSE <2.15 and
Syntax score >34.5. Each variable takes points according to multivariate analysis with total
score 20. ROC curve analysis was done to pick up the best cut off value of POAF Score and
incidence of POAF which revealed POAF Score more than 10 has sensitivity 99 % and
specificity 86% Area under the curve 0.99. Conclusion: POAF after CABG is associated with
higher morbidity and mortality, prolonged recumbence in the hospital. Prediction of POAF
might be useful in detection of patients at risk for these complications using POAF risk
score.