The retrospective research of postoperative atrial fibrillation in patients underwent coronary artery bypass grafting / 中华胸心血管外科杂志

ABSTRACT

Objective To research the influencing factors of postoperative atrial fibrillation( AF) in patients underwent coronary artery bypass grafting( CABG) , and to explore the relationship between postoperative AF with complications and recov-ery. Methods From January 2017 to February 2018, 2218 patients in Beijing Anzhen Hospital affiliated to Capital Medical University underwent simple CABG and returned to the ICU. After excluding preoperative AF and pacemaker implanted pa-tients, a total of 1952 patients were included in the research. According to whether there was postoperative AF, patients were dividedintonon-AFgroup[1544cases,male1017,female527,averagedage(63.20±9.47)yearsold]andnew-onsetAF group [408 cases, male 280, female 128, averaged age(69.32 ±8.93) years old]. The gender, age, related medical histo-ry, cardiac function and other factors were recorded. And the postoperative laboratory test indicators, tracheal reintubation rate, tracheotomy rate, mortality, IABP and ECMO use rate, intensive care unit and hospital time were compared. Results Compared with the non-AF group, the rates of tracheal reintubation(P=0. 007), tracheotomy(P=0. 039), and hospital mor-tality(P=0. 039) were higher on the new-onset AF group, and the postoperative mechanical ventilation time(P=0. 010), the ICU time(P=0. 037) and the hospital time(P=0. 045) were longer. Multivariate regression analysis showed: advanced age (P=0.028), postoperative cardiogenic shock(P=0.033), postoperative AKI(P=0.041), postoperative CRP elevation(P=0. 030), postoperative TNI elevation(P=0. 028) and postoperative LAC elevation(P=0. 044) were independent risk fac-tors for postoperative new-onset AF in CABG patients. Conclusion Patients with new-onset AF after CABG have higher com-plication and mortality rate. It is necessary to prevent the occurrence of AF and improve the heart and vital organ function in time to reduce the mortality.