Achmad Chaerul, Tiksnadi Badai Bhatara, Akbar Mohammad Rizki, Karwiky Giky, Sihite Teddy Arnold, Pramudya Arsha, Iqbal Mohammad, Febrianora Mega
Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital -Universitas Padjadjaran, Bandung, West Java, Indonesia; Hasna Medika Cardiac Hospital, Cirebon, Indonesia.
Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital -Universitas Padjadjaran, Bandung, West Java, Indonesia.
Curr Probl Cardiol. 2023 Mar;48(3):101031. doi: 10.1016/j.cpcardiol.2021.101031. Epub 2021 Oct 27.
Preoperative left atrial remodeling as Postoperative atrial fibrillation (POAF) predisposing factors could be measured by left atrial volume index (LAVI) and P-wave dispersion. This study aimed to assess P-wave dispersion and LAVI as preoperative predictors of POAF among patients who underwent Coronary Artery Bypass Graft (CABG). An analytical retrospective cohort study was performed on patients who underwent CABG. The P-wave dispersion and POAF were evaluated based on documented ECG results. LAVI size was collected from echocardiographic reports. Hazard ratios of P-wave dispersion and LAVI for POAF were analyzed using Cox proportional hazard model. A total of 42 subjects (57 ± 1 years) were included in this study. POAF occurred in 28.6% of patients at a median of 2 days after CABG. P-wave dispersion was significantly longer in patients in whom AF was developed (53.03 ± 3.82 ms vs 44.01 ± 1.98ms, p:0.028), while LAVI difference was not significant. The Cox proportional hazard model showed a significant association between P-wave dispersion and risk of POAF (HR 1.05, CI95%, 1.001-1.103; P = 0.048). There was no association between LAVI and risk of POAF (HR 1.003, CI 95%, 0.965-1.044; P = 0.864). P-wave dispersion is a predictor of POAF in patients who underwent CABG. Risk stratification using P-wave dispersion enables clinicians to identify high-risk patients before CABG surgery.
术前左心房重塑作为术后房颤（POAF）的诱发因素，可通过左心房容积指数（LAVI）和P波离散度来衡量。本研究旨在评估P波离散度和LAVI作为冠状动脉旁路移植术（CABG）患者POAF术前预测指标的价值。对接受CABG的患者进行了一项分析性回顾性队列研究。根据记录的心电图结果评估P波离散度和POAF。从超声心动图报告中收集LAVI大小。使用Cox比例风险模型分析P波离散度和LAVI对POAF的风险比。本研究共纳入42名受试者（57±1岁）。28.6%的患者在CABG术后中位2天发生POAF。发生房颤的患者P波离散度明显更长（53.03±3.82毫秒对44.01±1.98毫秒，p：0.028），而LAVI差异不显著。Cox比例风险模型显示P波离散度与POAF风险之间存在显著关联（HR 1.05，CI95%，1.001 - 1.103；P = 0.048）。LAVI与POAF风险之间无关联（HR 1.003，CI 95%，0.965 - 1.044；P = 0.864）。P波离散度是接受CABG患者POAF的预测指标。使用P波离散度进行风险分层可使临床医生在CABG手术前识别高危患者。
