Predictors of postoperative atrial fbrillation in patients older than 60 years with preserved ejection fraction after coronary artery bypass grafting

Objective: to identify predictors of early postoperative atrial fbrillation (POAF) in patients over 60 years of age with preserved ejection fraction following isolated coronary artery bypass grafting (CABG). Material and methods. A retrospective analysis included data from 195 patients (mean age 64 ± 7.2 years; 73% male) who underwent isolated CABG. The study examined medical history, laboratory and instrumental parameters before and after surgery, intraoperative indices, and medication therapy. Clinically signifcant paroxysms of atrial fbrillation were defned as episodes lasting more than 30 seconds occurring within the frst 7 days post-CABG. Results. POAF developed in the early postoperative period in 43 patients (22%), constituting Group 1. The remaining 152 patients (78%) formed Group 2. Comparative analysis revealed statistically signifcant diferences between the groups in the severity of New York Heart Association functional class (FC) for chronic heart failure (CHF) (p<0.001) and left atrial diameter (LAD). Specifcally, LAD was 41 [38–43] mm in Group 1 vs 38 [35–41] mm in Group 2 (p=0.007). The combination of CHF FC III and an LAD>38 mm signifcantly increased the likelihood of developing POAF (odds ratio 8.909, 95% confdence interval 2.855–27.801; p<0.001). Conclusion. In patients over 60 years old with a preserved ejection fraction undergoing isolated CABG, the predictor for the development of POAF is the combined presence of an enlarged left atrium (diameter>38 mm) and CHF FC III.