Right atrial dyssynchrony and Atrial Fibrillation after coronary Bypass Graft Surgery

Abstract

Introduction: Prevalence of post-coronary bypass grafting surgery (post-CABG) atrial fibrillation (AF) is high, and it’s complications are serious. Prediction of this problem and prophylactic or presumably curative managements may be helpful not only in post-CABG AF, but also in other conditions that predispose patients to AF. The aim of this study was finding relationship between right atrial (RA) dyssynchrony and post-CABG AF occurrence. Methods: One hundred patients who were candidates for CABG and they had sinus rhythm was evaluated. We measured RA dyssynchrony in tissue Doppler imaging (TDI) using initiation of P wave in the electrocardiogram to peak A wave (on TDI) in mid of RA free wall and mid of inter-atrial septum (IAS). The time difference from the onset of the P wave to the onset of the A wave at the right atrium (P-RA) and the IAS (P-IAS) was measured. RA dyssynchriny was defined as the difference between P-IAS and the P-RA. Patients were followed for occurrence of AF 72 h after CABG through Holter monitoring, the relation between AF occurrence and RA dyssynchrony was determined. Results: AF developed in 24 patients (24%), based on statistical analysis, lower LVEF and RA dyssynchrony had relationship with AF occurrence. RA dyssynchrony was significantly increased in patients with postoperative AF (36.67 ± 14.93 ms vs. 14.27 ± 13.77 ms,P < 0.001). Conclusion: We demonstrated that RA dyssynchrony based on TDI could be a predictor for the occurrence of post-CABG AF.

Keywords: Atrial fibrillation, Right atrial dyssynchrony, coranary bypass graft