Role of atrial ischaemia in development of atrial fibrillation following coronary artery bypass surgery

Shyam Kolvekar, Anthony D'Souza, Parvez Akhatar, Chris Reek, Clifford Garratt, Tom Spyt

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Objective: Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting (CABG) operations, occurring in 5 to 40% of cases. A number of studies have implicated atrial ischaemia in the genesis of this arrhythmia. The aim of this study was to examine the relationship between atrial coronary anatomy and the incidence of post operative atrial fibrillation. Method: To investigate a possible anatomical explanation to the onset of AF after CABG, 25 patients with documented AF after CABG were matched and compared to 25 patients which remained in sinus rhythm (SR). All coronary angiograms were reported blindly to the blood supply of the sino-atrial (SA) node and atrio-ventricular (AV) node before and after surgery. Results: Univariate analysis of risk factors did not identify any significant difference (Fisher exact test, P > 0.05) between the two groups in age, gender, left ventricular function, ischaemic time, number of vessels diseased or grafted, renal dysfunction and withdrawal of beta-blockade. However, significant disease in the SA nodal artery was present in 2 patients of the SR group when compared to 9 in the AF group. Significant disease of AV nodal artery was present in only 4 patients of the SR group when compared to 18 in the AF group. Comparison between the two groups showed a significantly increased incidence of SA or AV nodal artery disease in the AF group, (SA: P = 0.018, AV: P = 0.0001). Mean hospital stay was 8.1 days for the SR group and 9.1 days in the AF group (P = 0.175). Conclusion: Obstructive disease in the SA nodal and AV nodal arteries is more common in patients developing atrial fibrillation following coronary artery bypass surgery than those who remain in sinus rhythm. If the incidence of AF could be predicted by the anatomical distribution of arterial disease then targeting prophylaxis to this group may be possible.

Original languageEnglish
Pages (from-to)70-75
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Volume11
Issue number1
DOIs
Publication statusPublished - 01-1997

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Coronary Artery Bypass
Atrial Fibrillation
Ischemia
Arteries
Incidence
Atrioventricular Node
Sinoatrial Node
Left Ventricular Function
Cardiac Arrhythmias
Length of Stay
Anatomy
Angiography
Age Groups
Kidney

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Kolvekar, Shyam ; D'Souza, Anthony ; Akhatar, Parvez ; Reek, Chris ; Garratt, Clifford ; Spyt, Tom. / Role of atrial ischaemia in development of atrial fibrillation following coronary artery bypass surgery. In: European Journal of Cardio-thoracic Surgery. 1997 ; Vol. 11, No. 1. pp. 70-75.
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abstract = "Objective: Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting (CABG) operations, occurring in 5 to 40{\%} of cases. A number of studies have implicated atrial ischaemia in the genesis of this arrhythmia. The aim of this study was to examine the relationship between atrial coronary anatomy and the incidence of post operative atrial fibrillation. Method: To investigate a possible anatomical explanation to the onset of AF after CABG, 25 patients with documented AF after CABG were matched and compared to 25 patients which remained in sinus rhythm (SR). All coronary angiograms were reported blindly to the blood supply of the sino-atrial (SA) node and atrio-ventricular (AV) node before and after surgery. Results: Univariate analysis of risk factors did not identify any significant difference (Fisher exact test, P > 0.05) between the two groups in age, gender, left ventricular function, ischaemic time, number of vessels diseased or grafted, renal dysfunction and withdrawal of beta-blockade. However, significant disease in the SA nodal artery was present in 2 patients of the SR group when compared to 9 in the AF group. Significant disease of AV nodal artery was present in only 4 patients of the SR group when compared to 18 in the AF group. Comparison between the two groups showed a significantly increased incidence of SA or AV nodal artery disease in the AF group, (SA: P = 0.018, AV: P = 0.0001). Mean hospital stay was 8.1 days for the SR group and 9.1 days in the AF group (P = 0.175). Conclusion: Obstructive disease in the SA nodal and AV nodal arteries is more common in patients developing atrial fibrillation following coronary artery bypass surgery than those who remain in sinus rhythm. If the incidence of AF could be predicted by the anatomical distribution of arterial disease then targeting prophylaxis to this group may be possible.",
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Role of atrial ischaemia in development of atrial fibrillation following coronary artery bypass surgery. / Kolvekar, Shyam; D'Souza, Anthony; Akhatar, Parvez; Reek, Chris; Garratt, Clifford; Spyt, Tom.

In: European Journal of Cardio-thoracic Surgery, Vol. 11, No. 1, 01.1997, p. 70-75.

Research output: Contribution to journalArticle

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