Left Volume Atrial Index and P-Wave Dispersion as Predictors of
Postoperative Atrial Fibrillation after Coronary Artery Bypass Graft: a
Retrospective Cohort Study
Abstract
Background: Preoperative left atrial remodeling as Postoperative atrial
fibrillation (POAF) predisposing factors could be measured by left
atrial volume index (LAVI) and P-wave dispersion. Aim: This study aimed
to assess P-wave dispersion and LAVI as preoperative predictors of POAF
among patients who underwent Coronary Artery Bypass Graft (CABG).
Methods: 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. Result: 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±3.82ms 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 (HR1.003, CI 95%, 0.965-1.044;p=0.864). Conclusion: 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.