What is the clinical evidence from this study?

Study design: Cohort. Population: Low-risk patients undergoing isolated off-pump coronary artery bypass grafting (OPCAB) (n=123). Intervention: Left atrial strain. Primary outcome: Early postoperative atrial fibrillation (POAF) (OR 0.67, 95% CI 0.50-0.89, p=0.006).

August 27, 2026Annals of Noninvasive ElectrocardiologyOpen Access

The Value of Left Atrial Strain and Strain Rate for Prediction of Early Postoperative Atrial Fibrillation Following Isolated Off‐Pump Coronary Artery Bypass Grafting in Low‐Risk Patients

Q: What are the key findings of this study?

A 1-unit increase in preoperative left atrial strain was associated with a 33% decrease in the odds of early postoperative atrial fibrillation (OR 0.67, 95% CI 0.50-0.89, p=0.006).

Q: What does this research mean for the field?

A 1-unit increase in preoperative left atrial strain is associated with a 33% decrease in the odds of early postoperative atrial fibrillation in low-risk patients undergoing isolated off-pump coronary artery bypass grafting. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Higher preoperative left atrial strain is linked to ~33% lower odds of early POAF.

OR 0.67
95% CI 0.50-0.89
P=0.006
n=123

Why the study?

Postoperative atrial fibrillation is prevalent after CABG, but reliable approaches to predict early POAF are lacking, particularly in low-risk subjects.

Does preoperative left atrial strain predict early postoperative atrial fibrillation in low-risk patients undergoing isolated off-pump coronary artery bypass grafting?

Key Points

To assess how effectively preoperative left atrial strain and strain rate predict early postoperative atrial fibrillation in low-risk patients undergoing isolated off-pump coronary artery bypass grafting.
Prospective study of 123 low-risk patients in sinus rhythm undergoing isolated off-pump coronary artery bypass grafting.
Preoperative left atrial strain and left atrial strain rate were measured using velocity vector imaging.
Patients were monitored postoperatively for 1 week to detect early postoperative atrial fibrillation.
Early postoperative atrial fibrillation occurred in 12.2% of patients (n = 15), who showed significantly lower left atrial strain (21.25 vs. 37.59, p < 0.001) and strain rate (1.37 vs. 2.73, p < 0.001) compared to patients without the arrhythmia.
Multivariable logistic regression identified left atrial strain as the only independent predictor of early postoperative atrial fibrillation (OR = 0.67, 95% CI: 0.50–0.89; p = 0.006), with each 1-unit increase associated with a 33% reduction in odds.

Study Design

Type

Cohort (n=123)

Multicenter

Structured PICO

Does preoperative left atrial strain predict early postoperative atrial fibrillation in low-risk patients undergoing isolated off-pump coronary artery bypass grafting?

Population

123 low-risk adults with sinus rhythm undergoing isolated off-pump coronary artery bypass grafting, followed for 1 week.

Exposure

Preoperative left atrial strain and strain rate measurement using velocity vector imaging (VVI)

Outcome

Early postoperative atrial fibrillation (POAF) within 1 week post-surgeryhard clinical

Main Result

Odds Ratio: 0.67 (95% CI 0.5–0.89)

p-value: p=0.006

Preoperative left atrial strain measurement can independently predict early postoperative atrial fibrillation in low-risk patients undergoing off-pump CABG, potentially guiding targeted prophylactic therapy.

Limitations

Single center
Small sample size
Low number of POAF events
Short follow-up period (1 week)

Implication

May aid POAF risk stratification in low-risk off-pump CABG; hypothesis-generating pending prospective validation.

Abstract

BACKGROUND: Following coronary artery bypass grafting (CABG) surgery, postoperative atrial fibrillation (POAF) is a prevalent arrhythmia. Prior research has demonstrated a paucity of reliable approaches to predict early POAF after CABG, particularly in low-risk subjects. The present investigation proposed to assess how effectively left atrial (LA) strain and LA strain rate predict early POAF after isolated off-pump CABG (OPCAB) in low-risk individuals. METHODS: One hundred and twenty-three low-risk subjects with sinus rhythm who underwent isolated OPCAB were assessed in this prospective research. The velocity vector imaging (VVI) method was utilized to measure LA strain and LA strain rate. Subsequently, the patients were monitored post-surgery for 1 week to assess whether early POAF had occurred. RESULTS: In contrast to those who did not experience early POAF, individuals with early POAF showed significantly lower LA strain (21.25 vs. 37.59, p < 0.001), lower LA strain rate (1.37 vs. 2.73, p < 0.001), and higher left atrial volume index (LAVI) (p < 0.001). A 1-unit increase in LA strain was associated with a 33% decrease in the odds of early POAF (OR = 0.67, 95% CI: 0.50-0.89; p = 0.006). CONCLUSION: Preoperative left atrial strain measurements may serve as an effective predictor of early POAF in low-risk patients after isolated OPCAB. Rather than treating all patients undergoing CABG, identifying the group at greater risk for early POAF may enable targeted prophylactic therapy.

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Cite This Study

Bigdelu et al. (2026) conducted a cohort in Low-risk patients undergoing isolated off-pump coronary artery bypass grafting (OPCAB) (n=123). Left atrial strain was evaluated on Early postoperative atrial fibrillation (POAF) (OR 0.67, 95% CI 0.50-0.89, p=0.006). A 1-unit increase in preoperative left atrial strain was associated with a 33% decrease in the odds of early postoperative atrial fibrillation (OR 0.67, 95% CI 0.50-0.89, p=0.006).

synapsesocial.com/papers/6a8fe9b910c91c1e926218bd https://doi.org/10.1111/anec.70230