Frequency of New-Onset Atrial Fibrillation in Post-coronary Artery Bypass Grafting (CABG) Patients in the Cardiac ICU

BACKGROUND: Atrial fibrillation (AF) is a common complication following coronary artery bypass grafting (CABG) and is associated with increased morbidity and prolonged hospital stay. This study aimed to determine the frequency of new-onset atrial fibrillation (NOAF) in post-CABG patients and assess its association with demographic and clinical variables, including comorbidities. METHODS: This descriptive observational study was conducted in the Cardiac ICU of Rehman Medical Institute (RMI) over six months. A total of 101 post-CABG patients admitted to the ICU were included and monitored for the development of AF. Patients with congenital anomalies, a prior history of arrhythmias, or those who did not provide consent were excluded. Data were collected prospectively, including patient demographics, comorbidities, and antiarrhythmic management. Statistical analysis was performed using SPSS version 26 (Armonk, NY: IBM Corp.), with quantitative variables presented as means±standard deviations and qualitative variables as frequencies and percentages. RESULTS: The frequency of NOAF in post-CABG patients was found to be 13.86% (n=14). The mean age of the study population was 59.62 years (SD=9.81), with a male predominance (69 males, 32 females). Hypertension (HTN) and coronary artery disease (CAD) were the most common comorbidities, affecting 29.7% (n=30) and 20.8% (n=21) of patients, respectively. A trend was observed suggesting that patients with multiple comorbidities had an increased likelihood of developing AF, although this finding was descriptive and not statistically significant. Antiarrhythmic medications were administered in all AF cases, with a variable response. CONCLUSION: The incidence of NOAF in post-CABG patients remains significant based on previous researches. Age and pre-existing comorbidities, particularly hypertension and CAD, appear to contribute to AF development. Developing preoperative and intraoperative risk assessment tools may help identify patients at higher risk for post-CABG atrial fibrillation. Future interventional studies can evaluate strategies such as fluid management, early beta-blockers, or anti-inflammatory therapies to reduce the incidence of AF.