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Clinical Trial
. 2015:2015:703685.
doi: 10.1155/2015/703685. Epub 2015 Jul 28.

Incidence and Predictors of New-Onset Silent Atrial Fibrillation after Coronary Artery Bypass Graft Surgery

Charles Guenancia  1 , Charline Pujos  2 , Frederique Debomy  3 , Ghislain Malapert  2 , Gabriel Laurent  4 , Olivier Bouchot  5
Affiliations
Clinical Trial

Incidence and Predictors of New-Onset Silent Atrial Fibrillation after Coronary Artery Bypass Graft Surgery

Charles Guenancia et al. Biomed Res Int. 2015.

Abstract

Aims: We investigated the incidence, risk factors, and prognostic impact of silent atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery.

Methods: This observational study prospectively included 100 patients referred for CABG surgery. Holter ECG monitoring was used to record every arrhythmic event for 7 days. AF was defined as at least one episode >30 s. Episodes recorded on Holter ECG monitoring but not clinically identified were classified as silent AF.

Results: Among 34 patients who developed new-onset AF, 13 had silent AF. Compared with patients with maintained sinus rhythm (SR), silent AF patients had a significantly higher logistic EuroSCORE (2.9 (1.5-5.2) versus 2.3 (1.4-3.7), p = 0.017) and were more likely to have previous sleep apnea (31% versus 8%, p = 0.016) and left atrial diameter >45 mm (36% versus 5%, p = 0.002). At one-year follow-up, 30% of silent AF patients had developed symptomatic AF versus 7% in the SR group (p = 0.03) and 11% in the clinical AF group (p = 0.21).

Conclusion: After CABG surgery, silent AF is common and may be associated with a higher incidence of recurrences at one-year follow-up than clinical AF. Improved screening for silent AF may help to reduce thromboembolic events in this high-risk population.

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Figures

Figure 1
Figure 1
Flow chart of patient selection. AF: atrial fibrillation; CABG: coronary artery bypass graft surgery.
See this image and copyright information in PMC

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