Frequency of Development of Atrial Fibrillation After Coronary Artery Bypass Grafting in Different Age Groups	: Frequency of Development of Atrial Fibrillation

Adnan  Ali Khahro; Muhammad  Farhan Khan; Sana  Aslam; Mudassir  Iqbal Dar; Hafsa  Aurooj; Veena  Bai

doi:10.54393/pjhs.v4i04.644

Authors

Adnan Ali Khahro Liaquat University Hospital, Hyderabad Jamshoro, Pakistan
Muhammad Farhan Khan Gambat Institute of Medical Sciences, Gambat, Sindh, Pakistan
Sana Aslam Bilawal Medical College, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Mudassir Iqbal Dar Gambat Institute of Medical Sciences, Gambat, Sindh, Pakistan
Hafsa Aurooj Liaquat University Hospital, Hyderabad Jamshoro, Pakistan
Veena Bai Liaquat University Hospital, Hyderabad Jamshoro, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i04.644

Keywords:

Atrial Fibrillation, Coronary Artery Bypass Grafting, Atheroma, Ischemia

Abstract

Atrial fibrillation is a known complication in patients having coronary artery bypass grafting (CABG) surgery with a Post- up to 32% after CABG reported incidence up to 32%. Objective: To determine the frequency of development of atrial fibrillation after coronary artery bypass grafting surgery in different age groups. Methods: This was an observational prospective cross sectional study, conducted at department of cardiac surgery Dr Ruth.K.M.Pfau Civil Hospital Karachi. The sample size of 199 was calculated. All patients between the ages of 30-70years. Irrespective of gender, refer for CABG surgery was included in the study. Two groups were made on the basis of their age, group 1, 30-50 years and group 2, 51-70 years. Those patients who came for CABG along with valve replacement and or other concomitant surgery were not included in my study. Results: After data collection through Performa data analyzed on SPSS 17.0. As per results 20.1% individuals in the study developed atrial fibrillation. Male to female ratio was 3: 1. In Group 1, 16.6% patients developed Atrial Fibrillation and in group 2 21.58% developed Atrial Fibrillation with p value of 0.85. Hypertension was a commonest co-morbid and present in 56.2% patients in this study. Conclusion: The study concluded that the frequency of development of atrial fibrillation after CABG as 20.10 %. Patients with positive family history of coronary artery diseases and smokers have significantly higher risk to develop atrial fibrillation after surgery.

References

Švagždienė M, Širvinskas E, Benetis R, Ralienė L, Šimatonienė V. Atrial fibrillation and changes in serum and urinary electrolyte levels after coronary artery bypass grafting surgery. Medicina. 2009 Dec; 45(12): 960-70. doi: 10.3390/medicina45120123

Abbaszadeh M, Khan ZH, Mehrani F, Jahanmehr H. Perioperative intravenous corticosteroids reduce incidence of atrial fibrillation following cardiac surgery: a randomized study. Brazilian Journal of Cardiovascular Surgery. 2012; 27: 18-23. doi: 10.5935/1678-9741.20120005

Dave S, Nirgude A, Gujjar P, Sharma R. Incidence and risk factors for development of atrial fibrillation after cardiac surgery under cardiopulmonary bypass. Indian Journal of Anaesthesia. 2018 Nov; 62(11): 887-91. doi: 10.4103/ija.IJA_6_18

Thorén E, Hellgren L, Jidéus L, Ståhle E. Prediction of postoperative atrial fibrillation in a large coronary artery bypass grafting cohort. Interactive cardiovascular and thoracic surgery. 2012 May; 14(5): 588-93. doi: 10.1093/icvts/ivr162

Golmohammadi M, Javid GE, Farajzadeh H. Incidence and risk factors for atrial fibrillation after first coronary artery bypass grafting in Urumiyeh imam Khomeini Hospital from 2006 to 2008. International Cardiovascular Research Journal. 2010 Jun; 4(2): 86-90.

Dupont E, Ko YS, Rothery S, Coppen SR, Baghai M, Haw M, et al. The gap-junctional protein connexin40 is elevated in patients susceptible to postoperative atrial fibrillation. Circulation. 2001 Feb; 103(6): 842-9. doi: 10.1161/01.CIR.103.6.842

Karaca M, Demirbas MI, Biceroglu S, Cevik A, Cetin Y, Arpaz M, et al. Prediction of early postoperative atrial fibrillation after cardiac surgery: is it possible? The value of interatrial conduction time for the prediction of early postoperative atrial fibrillation using intra-operative transoesophageal echocardiography: cardiovascular topics. Cardiovascular Journal of Africa. 2012 Feb; 23(1): 34-6. doi: 10.5830/CVJA-2011-010

Bramer S, van Straten AH, Hamad MA, Berreklouw E, Martens EJ, Maessen JG. The impact of new-onset postoperative atrial fibrillation on mortality after coronary artery bypass grafting. The Annals of thoracic surgery. 2010 Aug; 90(2): 443-9. doi: 10.1016/j.athoracsur.2010.03.083

Reinhart RA, Marx Jr JJ, Broste SK, Haas RG. Myocardial magnesium: relation to laboratory and clinical variables in patients undergoing cardiac surgery. Journal of the American College of Cardiology. 1991 Mar; 17(3): 651-6. doi: 10.1016/S0735-1097(10)80179-2

Creswell LL, Schuessler RB, Rosenbloom M, Cox JL. Hazards of postoperative atrial arrhythmias. The Annals of thoracic surgery. 1993 Sep; 56(3): 539-49. doi: 10.1016/0003-4975(93)90894-N

Aranki SF, Shaw DP, Adams DH, Rizzo RJ, Couper GS, VanderVliet M, et al. Predictors of atrial fibrillation after coronary artery surgery: current trends and impact on hospital resources. Circulation. 1996 Aug; 94(3): 390-7. doi: 10.1161/01.CIR.94.3.390

Mathew JP, Parks R, Savino JS, Friedman AS, Koch C, Mangano DT, et al. Atrial fibrillation following coronary artery bypass graft surgery: predictors, outcomes, and resource utilization. Jama. 1996 Jul; 276(4): 300-6. doi: 10.1001/jama.276.4.300

Taylor GJ, Mikell FL, Moses HW, Dove JT, Katholi RE, Malik SA, et al. Determinants of hospital charges for coronary artery bypass surgery: the economic consequences of postoperative complications. The American journal of cardiology. 1990 Feb; 65(5): 309-13. doi: 10.1016/0002-9149(90)90293-A

Lahey SJ, Campos CT, Jennings B, Pawlow P, Stokes T, Levitsky S. Hospital readmission after cardiac surgery. Does" fast track" cardiac surgery result in cost saving or cost shifting?. Circulation. 1998 Nov; 98(19): 35-40.

Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation: a major contributor to stroke in the elderly: the Framingham Study. Archives of internal medicine. 1987 Sep; 147(9): 1561-4. doi: 10.1001/archinte.147.9.1561

Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. stroke. 1991 Aug; 22(8): 983-8. doi: 10.1161/01.STR.22.8.983

Davies MJ and Pomerance A. Pathology of atrial fibrillation in man. British heart journal. 1972 May; 34(5): 520-5. doi: 10.1136/hrt.34.5.520

Spach MS and Dolber PC. Relating extracellular potentials and their derivatives to anisotropic propagation at a microscopic level in human cardiac muscle. Evidence for electrical uncoupling of side-to-side fiber connections with increasing age. Circulation research. 1986 Mar; 58(3): 356-71. doi: 10.1161/01.RES.58.3.356

Noyez L, Janssen DP, van Druten JA, Skotnicki SH, Lacquet LK. Coronary bypass surgery: what is changing? Analysis of 3834 patients undergoing primary isolated myocardial revascularization. European journal of cardio-thoracic surgery. 1998 Apr; 13(4): 365-9. doi: 10.1016/S1010-7940(98)00039-6

Mulay A, Kirk AJ, Angelini GD, Wisheart JD, Hutter JA. Posterior pericardiotomy reduces the incidence of supra-ventricular arrhythmias following coronary artery bypass surgery. European journal of cardio-thoracic surgery. 1995 Jan; 9(3): 150-2. doi: 10.1016/S1010-7940(05)80063-6

Magee MJ, Herbert MA, Dewey TM, Edgerton JR, Ryan WH, Prince S, et al. Atrial fibrillation after coronary artery bypass grafting surgery: development of a predictive risk algorithm. The Annals of thoracic surgery. 2007 May; 83(5): 1707-12. doi: 10.1016/j.athoracsur.2006.12.032

Fuller JA, Adams GG, Buxton B. Atrial fibrillation after coronary artery bypass grafting: is it a disorder of the elderly?. The Journal of thoracic and cardiovascular surgery. 1989 Jun; 97(6): 821-5. doi: 10.1016/S0022-5223(19)34483-6

Borzak S, Tisdale JE, Amin NB, Goldberg AD, Frank D, Padhi ID, et al. Atrial fibrillation after bypass surgery: does the arrhythmia or the characteristics of the patients prolong hospital stay?. Chest. 1998 Jun; 113(6): 1489-91. doi: 10.1378/chest.113.6.1489

Crosby LH, Pifalo WB, Woll KR, Burkholder JA. Risk factors for atrial fibrillation after coronary artery bypass grafting. The American journal of cardiology. 1990 Dec; 66(20): 1520-2.doi: 10.1016/0002-9149(90)90550-K

Golmohammadi M, Javid GE, Farajzadeh H. Incidence and risk factors for atrial fibrillation after first coronary artery bypass grafting in Urumiyeh imam Khomeini Hospital from 2006 to 2008. International Cardiovascular Research Journal. 2010 Jun; 4(2).