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Ann Thorac Surg 2000;69:1064-1069
© 2000 The Society of Thoracic Surgeons
a Department of Thoracic and Cardiovascular Surgery, University Hospital, Uppsala, Sweden
b Department of Cardiology, University Hospital, Uppsala, Sweden
c Department of Clinical Chemistry, University Hospital, Uppsala, Sweden
d Department of Physiology, University of Uppsala, Uppsala, Sweden
Address reprint requests to Dr Jidéus, Department of Thoracic and Cardiovascular Surgery, University Hospital, S-751 85 Uppsala, Sweden
e-mail: lena.jideus{at}kirurgi.uu.se
Background. We evaluated the role of supraventricular arrhythmias and assessed clinical predictors of atrial fibrillation (AF) that developed after coronary artery bypass operations.
Methods. Eighty patients, with a mean age of 65.8 years, underwent 24-hour Holter monitoring preoperatively and for 4 consecutive days postoperatively, or until clinically documented AF, for analysis of the number of premature beats and tachyarrhythmias. Atrial areas and atrial peptides were measured preoperatively and postoperatively.
Results. Twenty-nine of 80 (36.3%) patients had postoperative AF. Preoperatively, the maximal supraventricular premature beats per minute were higher in the AF group (p = 0.02). The body mass index and total amount of cardioplegia were lower (p = 0.02 and p = 0.006, respectively), and withdrawal of ß-blockers postoperatively more frequent (p = 0.001) in the AF group, but atrial areas and atrial peptides did not differ.
Conclusions. Frequent supraventricular premature beats preoperatively may indicate a propensity for AF. A larger amount of cardioplegia during the cross-clamp period may reduce the risk of postoperative AF. Further studies are mandatory to clarify why patients with lower body mass index were more prone to AF.
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