Prediction of postoperative atrial fibrillation with postoperative epicardial electrograms.

Feilberg Rasmussen, Louise ORCID: 0000-0002-7455-1265, Andreasen, Jan Jesper, Riahi, Sam ORCID: 0000-0003-1849-9463, Lip, Gregory YH ORCID: 0000-0002-7566-1626, Lundbye-Christensen, Søren ORCID: 0000-0002-9420-2783, Melgaard, Jacob and Graff, Claus ORCID: 0000-0001-9650-9781 (2022) Prediction of postoperative atrial fibrillation with postoperative epicardial electrograms. Scandinavian cardiovascular journal : SCJ, 56 (1). pp. 378-386.

Access the full-text of this item by clicking on the Open Access link.

Official URL: http://dx.doi.org/10.1080/14017431.2022.2130421

Abstract

Objectives. New-onset postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery. The arrhythmia often entails a longer hospital stay, greater risk of other complications, and higher mortality both short- and long-term. An investigation of the use of early atrial electrograms in predicting POAF in cardiac surgery was performed. Design. In this prospective observational study, a total of 99 consecutive adult patients undergoing coronary artery bypass grafting, valve surgery or both were included. On the first postoperative morning, standard 12-lead electrograms (ECG), unipolar atrial electrograms (aEG), and vital values were recorded. The outcome was new-onset POAF within one month postoperatively. Results. Three multivariable prediction models for POAF were formed using measurements derived from the ECG, aEG, and patient characteristics. Age, body mass index, and two unipolar electrogram measurements quantifying local activation time and fractionation were strongly associated with the outcome POAF. The performance of the POAF prediction models was assessed through receiver operating curve characteristics with cross-validation, and discrimination using the leave-one-out-method to internally validate the models. The cross-validated area under the receiver operating characteristic curve (AUC) was improved in a prediction model using atrial-derived electrogram variables (AUC 0.796, 95% CI 0.698-0.894), compared with previous ECG and clinical models (AUC 0.716, 95% CI 0.606-0.826 and AUC 0.718, 95% CI 0.613-0.822, respectively). Conclusions. This study found that easily obtainable measurements from atrial electrograms may be helpful in identifying patients at risk of POAF in cardiac surgery.

Item Type:	Article
Uncontrolled Keywords:	Humans, Atrial Fibrillation, Postoperative Complications, Coronary Artery Bypass, Risk Factors, Predictive Value of Tests, Adult
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	12 Oct 2023 15:56
Last Modified:	12 Oct 2023 15:56
DOI:	10.1080/14017431.2022.2130421
Open Access URL:	https://doi.org/10.1080/14017431.2022.2130421
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3173664