What question did this study set out to answer?

To determine whether pre-operative angiographic disease in the sinoatrial or atrioventricular nodal arteries is an independent risk factor for atrial fibrillation following coronary artery bypass graft surgery.

June 1, 2001European Journal of Cardio-Thoracic SurgeryOpen Access

Nodal vessels disease as a risk factor for atrial fibrillation after coronary artery bypass graft surgery

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Why the study?

Does the presence of diseased nodal arteries predict the development of atrial fibrillation after routine CABG surgery?

Population

200 patients undergoing routine CABG, aged ≤65 years, with no previous history of atrial fibrillation.

Comparison

Pre-operative angiographic evidence of diseased… vs Absence of diseased nodal arteries

Design

Case-control, All angiograms were reviewed by a single radiologist blinded to…

Follow-up

post-CABG

Authors

SASaud Al-ShanafeyKing Faisal Specialist Hospital & Research Centre

Discussion

Member takes

Implication

SA nodal disease may flag higher post-CABG AF risk; hypothesis-generating and needs prospective validation before any practice change.

Key Points

To determine whether pre-operative angiographic disease in the sinoatrial or atrioventricular nodal arteries is an independent risk factor for atrial fibrillation following coronary artery bypass graft surgery.
Retrospective case-control study evaluating 100 post-CABG atrial fibrillation cases and 100 non-AF post-CABG controls identified from the Society of Thoracic Surgeons database.
Pre-operative angiograms were assessed by a single blinded radiologist, and multivariable logistic regression evaluated the risk associated with diseased nodal vessels and nodal revascularization.
Significant sinoatrial artery disease occurred in 34 cases versus 21 controls, demonstrating a significant association with post-CABG atrial fibrillation (adjusted OR=2.093, 95% CI: 1.06–4.09, P=0.03).
Significant atrioventricular artery disease was observed in 78 cases versus 74 controls but showed no significant association with post-CABG atrial fibrillation (adjusted OR=1.04, 95% CI: 0.51–2.12, P=0.82).
Revascularization of the sinoatrial artery (6/10 vs 28/45; OR=0.91, 95% CI: 0.18–5.06, P=0.58) and atrioventricular artery (48/87 vs 30/65; OR=1.44, 95% CI: 0.72–2.88, P=0.27) did not significantly alter post-operative AF risk.

Structured PICO

Does the presence of diseased nodal arteries predict the development of atrial fibrillation after routine CABG surgery?

Population

200 patients (100 cases, 100 controls) undergoing routine CABG, aged ≤65 years, with no previous history of atrial fibrillation.

Intervention

Pre-operative angiographic evidence of diseased sinoatrial (SA) or atrioventricular (AV) nodal arteries

Comparator

Absence of diseased nodal arteries

Outcome

Development of atrial fibrillation (AF) post-CABGhard clinical

Pre-operative angiographic evidence of diseased sinoatrial arteries is a significant predictor of post-CABG atrial fibrillation, potentially identifying patients for targeted prophylaxis.

Cite This Study

Saud Al-Shanafey (2001) studied this question.

synapsesocial.com/papers/6a70eeec26770c2b8de0d55e https://doi.org/10.1016/s1010-7940(01)00725-4

Topics

Atrial fibrillation Persistent AF management Anticoagulation in AF AF ablation outcomes

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Nodal vessels disease as a risk factor for atrial fibrillation after coronary artery bypass graft surgery

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Nodal vessels disease as a risk factor for atrial fibrillation after coronary artery bypass graft surgery

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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