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RESEARCH ARTICLE
Year : 2017  |  Volume : 6  |  Issue : 3  |  Page : 3

Coronary artery anatomy and the occurrence of atrial fibrillation after coronary artery bypass surgery


1 Department of Cardiology, Rajaie Cardiovascular Medical and Research Center, University of Medical Sciences, Tehran, Iran
2 Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, University of Medical Sciences, Tehran, Iran

Correspondence Address:
Mohammadmehdi Peighambari
Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Vali-Asr St., Niayesh Blvd, Tehran
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.5812/cardiovascmed.40682

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Background: Atrial fibrillation (AF) is one of the most common complications occurring after cardiac surgeries. The incidence of post-operative AF is increasing continuously over the past decades and it is associated with lengthened hospital stay and risk of stroke. Objectives: This study was designed to examine the relationship between coronary artery involvement and the occurrence of AF after coronary artery bypass graft (CABG). Methods: This prospective observational study was to assess the relationship between the coronary artery involvement and the occurrence of post CABG surgery AF. Patients with chronic and paroxysmal AF before surgery were excluded. All patients had a complete evaluation by echocardiography, electrocardiography, and laboratory testing. The patients were monitored for 3 days after surgery and any tachycardia monitored as AF was noted. Patients were also divided into two groups of having post-operative AF and not having AF. Coronary artery involvement was defined using the Rentrop system. The coronary arteries were divided into 14 segments for better understanding of the lesions. Results: In this study 232 patients were selected, from which 106 patients had AF and 126 patients had sinus rhythm. The results of the present study confirmed that the older patients had a more frequent occurrence of AF after CABG (P < 0.001). There was no significant relationship between the right coronary artery (RCA) lesion and the development of AF after CABG. Proximal left anterior descending (LAD) artery lesion was associated with a higher occurrence of AF after CABG (P = 0.022). Patients with single vessel or two-vessel coronary artery disease had a more frequent occurrence of AF after CABG versus those with three vessel disease (P = 0.021). Conclusions: Although age has been the most important predictor for occurrence of AF after CABG in the past and present studies, there are many other variables affecting its occurrence. Out of the variables evaluated in this study, higher PAP, proximal LAD lesion, higher levels of BNP, and D dimer as well as single vessel and two vessel coronary artery diseases were noted to significantly predict a higher occurrence of AF after CABG.


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