Preoperative left atrial dysfunction and new-onset atrial fibrillation in cardiac surgery patients

Introduction

Postoperative atrial fibrillation is one of the most frequent complications after cardiopulmonary bypass (CPB). The aim of the present study was to investigate the correlation between preoperative left atrial dysfunction assessed by tissue Doppler and postoperative new-onset atrial fibrillation (NOAF) after coronary artery bypass grafting (CABG).

Methods

Preoperative transthoracic echocardiography Doppler was performed on elective cardiac surgery patients. Left atrial function was evaluated with tissue Doppler imaging of the mitral annulus.

Results

We studied 92 patients, 73 (79%) males and 19 (21%) females, mean age 67 ± 10 years, in preoperative sinus rhythm who underwent elective CABG surgery under CPB. Nineteen patients (20.6%) developed NOAF at 34 ± 12 postoperative hours. Patients with NOAF were older (71 ± 7 vs. 66 ± 10 years, P = 0.034), had a larger left atrial diameter (LAD), lower peak atrial systolic mitral annular Doppler velocity (A' m) and higher E'/A' ratio in a bivariate analysis. Stepwise logistic regression analysis showed that LAD (OR = 2.23, 95% CI = 1.05 to 4.76; P = 0.033) and lower A' m (OR = 0.70, 95% CI = 0.55 to 0.99; P = 0.034) were independently associated with postoperative NOAF.

Conclusion

A preoperative left atrial dysfunction assessed by tissue Doppler imaging may identify the patients at risk of postoperative NOAF.