Postoperative atrial fibrillation is not associated with an increase risk of stroke or the type and number of grafts: a single-center retrospective analysis

Abstract

Background: Atrial fibrillation (AF) and atrial flutter are the 2 most common types of dysrhythmia in patients undergoing coronary artery bypass graft (CABG) surgery and are associated with increased morbidity and mortality. We sought to explore the association between the type and quantity of bypass grafts and cardiovascular outcomes in patients with postoperative AF (POAF).

Hypothesis: The type and quantity of bypass grafts is associated with POAF.

Methods: We queried the Society of Thoracic Surgery National Database for CABG operations, both with and without valve procedures, performed at Baystate Medical Center between January 2002 and July 2007. We used multivariable logistic regression modeling to identify predictors of POAF and to explore the impact of AF on major adverse cardiac outcomes in this post-CABG population.

Results: A total of 3068 patients received CABG surgery, 187 (6.1%) of whom received concurrent valve replacement or repair. The incidence of POAF was 38.3%. POAF was significantly associated with readmission within 30 days (P < 0.009), increased length of stay (P << 0.0001), and a strong trend toward increased 30 day mortality (P = 0.058). There was no association between POAF and postoperative stroke (P = 0.92), graft type (P = nonsignificant) or number of grafts (P = nonsignificant).

Conclusions: Patients with POAF experienced increased morbidity and mortality as demonstrated by previous studies. Neither the number of grafts nor type of grafts was associated with POAF. Furthermore, the rate of stroke was not associated with POAF.