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The Journal of Thoracic and Cardiovascular Surgery, Vol 100, 338-342, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
JW Leitch, D Thomson, DK Baird and PJ Harris
The purpose of this study was to identify factors associated with atrial
fibrillation and flutter after coronary artery bypass grafting. The study
group consisted of a consecutive series of 5807 patients who underwent
coronary artery bypass grafting alone and who were in sinus rhythm
preoperatively. Atrial fibrillation and flutter were identified during
continuous monitoring or by clinical symptoms and signs; they occurred in
17.2% of the patients. The prevalence of atrial fibrillation and flutter
was directly related to age at operation, varying from 3.7% in patients
aged less than 40 years to 27.7% in patients aged 70 and over. In a
multivariate analysis, age remained the most important independent
predictor of atrial fibrillation and flutter (p less than 0.001). Other
independent predictors of atrial fibrillation and flutter were chronic
airflow limitation (p = 0.006), preoperative beta-adrenergic blockers (p =
0.011), and chronic renal failure (p = 0.04). Extent of coronary disease at
catheterization, history of a previous myocardial infarction, heart size on
chest x-ray film, and all operative factors measured, apart from year of
operation, were unassociated with atrial fibrillation and flutter. Thus
atrial arrhythmias after coronary artery bypass operations are most
strongly related to advanced age and are unassociated with preoperative
left ventricular function and extent of coronary disease.
ARTICLES
The importance of age as a predictor of atrial fibrillation and flutter after coronary artery bypass grafting
Department of Cardiology Surgery, Royal Prince Alfred Hospital, Camperdown, Sydney, Australia.
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