Prediction of atrial fibrillation via atrial electromechanical interval after coronary artery bypass grafting

Article

关键词: SIGNAL-AVERAGED ELECTROCARDIOGRAM;    INTRAVENOUS AMIODARONE;    CARDIAC-SURGERY;    HEART-SURGERY;    RISK;    ECHOCARDIOGRAPHY;    IMPACT;    TRIAL;    SIZE;    OLD;   

DOI  :  10.1161/CIRCULATIONAHA.107.727081

来源: SCIE

【 摘 要 】

Background - We assessed the validity of the atrial electromechanical interval, measured by transthoracic tissue Doppler echocardiography, in determining patients at risk of post - coronary artery bypass graft atrial fibrillation (AF). Methods and Results - This prospective study recruited 355 patients in sinus rhythm who were candidates for coronary artery bypass grafting. The patients underwent a preoperative transthoracic echocardiography with a tissue Doppler evaluation and were monitored with continuous ECG telemetry during their hospital stay. Sixty-eight patients had postoperative AF (19.2%), with the incident occurring 2.3 +/- 0.7 days after surgery. The median length of hospitalization was 7.0 days for the AF patients and 6.0 days for the non-AF patients (P < 0.0001). The subjects with postoperative AF differed from the sinus rhythm patients in that the former had a lower ejection fraction (40.4 +/- 8.5% versus 48.4 +/- 9.4%), a reduced maximal A- wave transmitral Doppler flow velocity (44.3 +/- 4.6 versus 53.3 +/- 10.9 cm/s), an increased total atrial volume (68.7 +/- 12.6 versus 55.3 +/- 11.8 mL), and a prolonged atrial electromechanical interval (141.9 +/- 13.4 versus 100.3 +/- 10.3 ms, respectively; P < 0.0001 for all). In addition, the AF patients were older than the sinus rhythm group (66.0 +/- 8.0 versus 59.8 +/- 8.5 years). The atrial electromechanical interval was the best independent discriminator of the history of AF. We defined a cutoff point for the atrial electromechanical interval and chose 120 milliseconds for categorization, which yielded 100% sensitivity and 94.8% specificity for the prediction of AF. Conclusions - The atrial electromechanical interval by transthoracic tissue Doppler echocardiography could be a valuable method for identifying patients vulnerable to post - coronary artery bypass graft AF.

【 授权许可】

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