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A novel electrocardiographic parameter for the prediction of atrial fibrillation after coronary artery bypass graft surgery “P wave peak time”

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Abstract

Objectives

Patients with postoperative atrial fibrillation (POAF) have increased risk of both short- and long-term mortality and morbidity; therefore, prediction of POAF is crucial in the preoperative period of the patients undergoing coronary artery bypass graft surgery. Electrocardiography (ECG) is the simplest and cost-effective tool in the preoperative workup of the patients for the prediction of POAF. A newly defined ECG parameter P wave peak time (PWPT) has been shown as a marker of atrial fibrillation development in non-surgical patients and we investigated its role in patients undergoing cardiac surgery.

Method

A total of 327 patients undergoing isolated or combined cardiac surgery were involved and the primary endpoint was defined as the development of POAF. The study population was divided into two groups based on the presence or absence of POAF. Groups were compared for both standard P wave parameters and for PWPT on surface ECG. The predictors of POAF were assessed by multivariate regression analysis.

Results

The frequency of POAF was 20.4% (n = 67). P wave peak time in leads D2 (65.1 ± 11.8 vs 57.2 ± 10, p < 0.01) and V1 (57.8 ± 18 vs 44.8 ± 12.3, p < 0.01) were longer in patients with POAF. In multivariate regression analysis, PWPT in leads DII and V1 were independent predictors of POAF (OR: 1.11, 95%CI: 1.02–1.21, p = 0.01, OR: 1.06, 95%CI: 1.00–1.13, p = 0.03 respectively).

Conclusion

PWPT in leads DII and V1 can predict the development of POAF in patients undergoing cardiac surgery.

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Authors and Affiliations

  1. Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, University of Health Scienses, Tıbbiye Cad. No:13 Selimiye, 34886, Üsküdar/İstanbul, Turkey

    Ahmet Zengin, Mehmet Baran Karataş, Yiğit Çanga, Levent Pay, Semih Eren, Ali Nazmi Çalık & Özge Güzelburç

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  1. Ahmet Zengin
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  2. Mehmet Baran Karataş
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Correspondence to Ahmet Zengin.

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05.06.2020 – 28001928

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Zengin, A., Karataş, M.B., Çanga, Y. et al. A novel electrocardiographic parameter for the prediction of atrial fibrillation after coronary artery bypass graft surgery “P wave peak time”. Ir J Med Sci 191, 2579–2585 (2022). https://doi.org/10.1007/s11845-021-02894-8

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  • DOI: https://doi.org/10.1007/s11845-021-02894-8

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