Use of conventional and strain 2D echocardiography to predict atrial fibrillation after coronary artery bypass grafting

Abstract

Considering that post-operative atrial fibrillation is a common complication after coronary artery bypass grafting, which may lead to various complications such as increased length of hospitalization, increased health costs and mortality, atrial dysfunction is a factor. important in the creation of POAF, in this study, we decided to evaluate the role of left atrial function in patients who undergo CABG using conventional echocardiography and 2D strain echocardiography of the left atrium, which is an easy, non-invasive and available method. Result The result of the plan can help in predicting the probability of AF occurrence after CABG and preventing AF complications. Materials and Methods: In this cross-sectional study, all patients with sinus rhythm who undergo Elective CABG at Shahid Madani Hospital in Tabriz were included in the study in the period of six months ending in February of 2019. Demographic information of the patients and angiographic information including the number and name of the vessels involved, and then the patient's operation information including the number of received clamps, pump time, cross-clamp time, complications during surgery (such as arrhythmia, etc.), Off or On The presence of a surgical pump was included in the checklist. After surgery, patients were subjected to Holter monitoring for 72 hours during hospital ICU hospitalization in terms of the occurrence of AF that lasted for at least 5 minutes (Holter monitoring was done immediately after the patient was placed in the ICU). In case of not having enough number of Holters, necessary coordination was done with the nurse of the patient in the ICU for the accurate monitoring of the patient in terms of the occurrence of AF and the monitor and its detection. Holter data was analyzed by a cardiac electrophysiologist. Then, the findings obtained from echocardiography before surgery were analyzed with the information obtained from Holter monitoring after surgery, and the factors predicting the occurrence of AF in echocardiography in patients with AF were determined, regardless of the risk factors of the patients. Results: Two indicators, LAVI and LA global strain, have favorable predictive power in the diagnosis of POAF; This means that an increase in the LAVI index leads to an increase in the probability of having AF and an increase in the LA global strain index leads to a decrease in the incidence of AF.