[Value of interatrial conduction time and P wave dispersion in the prediction of atrial fibrillation following coronary bypass surgery].

OBJECTIVE

This prospective observational study investigated predictive power of interatrial conduction time (IACT) and P wave dispersion (PWD), in addition to other atrial fibrillation (AF) predictors, in patients undergoing coronary artery bypass surgery (CABG).

METHODS

Eighty-one patients undergoing CABG were enrolled. Before surgery, IACT and PWD were measured. Time interval from electrocardiographic P wave to echocardiographic transmitral a wave was defined as IACT. Rhythm monitorization was used for AF detection. Continuous and categorical data were compared with independent samples t test and Chi-square statistics. Multiple logistic regression analysis was used to identify independent AF predictors.

RESULTS

During a follow-up period of 6.4 ± 2.1 days, AF developed in 14 patients (17%). There were no significant differences between patients with or without AF according to age, gender, number of bypass grafts, cross-clamp duration, systolic function, and left atrial diameter. Significantly increased PWD and IACT were found in AF group (PWD: 37 ± 9 ms vs 24 ± 8 ms, p=0.005 and IACT: 129 ± 11 ms vs 117 ± 11 ms, p=0.01) as compared to group without AF. Increased PWD (OR 1.17; 95% CI 1.04-1.31; p=0.02), absence of beta-blocker treatment (OR 8.88; 95% CI 1.62-48.45; p=0.01), diabetes (DM) and hypertension (HT) combination (OR 1.45; 95% CI 1.15-4.22; p=0.01) were independent AF predictors. However, IACT predictive power had borderline significance (OR 1.03; 95% CI 0.95-1.12; p=0.06).

CONCLUSION

Increased PWD, absence of beta-blocker therapy, HT-DM combination were independent AF predictors following CABG. There was significant difference between groups according to IACT, however predictive value of IACT was nonsignificant. Other studies are needed to establish predictive power of IACT.