HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Idris Ali Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Al-Shanafey, S. Articles by Dobson, R. Search for Related Content PubMed PubMed Citation Articles by Al-Shanafey, S. Articles by Dobson, R. Related Collections Coronary disease Electrophysiology - arrhythmias

Eur J Cardiothorac Surg 2001;19:821-826
© 2001 Elsevier Science NL

Nodal vessels disease as a risk factor for atrial fibrillation after coronary artery bypass graft surgery

^a Cardiovascular Surgery Division, Maritime Heart Center, New Halifax Infirmary, Queen Elizabeth II Hospital, Halifax, Nova Scotia, Canada
^b Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada

Received 30 November 2000; received in revised form 13 March 2001; accepted 3 April 2001.

Corresponding author. Tel.: +1-902-473-2356; fax: +1-902-473-4448
e-mail: idrisali{at}doctor.com

Objective: Atrial fibrillation (AF) is common after coronary artery bypass graft (CABG) surgery. Atrial ischaemia due to diseased atrioventricular (AV) and sinoatrial (SA) arteries has been proposed as a cause of AF post-CABG. We examined if the presence of diseased nodal arteries was a significant predictor of the development of AF post-CABG. Methods: 100 consecutive cases (AF post-CABG) were compared to 100 consecutive controls (No AF post-CABG) with respect to pre-operative angiographic evidence of diseased nodal arteries. Cases and controls identified from the Society of Thoracic Surgeons database underwent detailed chart reviews to obtain data on potential risk factors. Patients were excluded if they were undergoing anything but a routine CABG procedure, were older than 65 years, or had previous AF. All angiograms were reviewed by a single radiologist blinded to outcome. The effect of grafting diseased nodal arteries on the development of AF post-CABG was also measured. A multiple logistic regression model was utilized to measure the effect of disease in each artery on the development of AF post-CABG. Results: Cases and controls were comparable regarding potential risk factors, with the exception that the AF group was older than the non-AF group. Significant AV artery disease was detected in 78 cases compared to 74 controls (adjusted odds ratio (OR) OR=1.04, CI, 0.51–2.12, P=0.82). Significant SA artery disease was detected in 34 cases compared to 21 controls (adjusted OR=2.093, CI: 1.06–4.09, P=0.03). Six of ten patients having revascularization of their SA nodal artery developed AF versus 28 of 45 of those who did not (OR=0.91, CI: 0.18–5.06, P=0.58). Forty-eight of 87 patients having revasacularization of their AV nodal artery developed AF versus 30 of 65 of those who did not (OR=1.44, CI: 0.72–2.88, P=0.27). Conclusion: The presence of a diseased SA artery is significantly associated with AF post-CABG. Such association may be used to identify a subset of patients who might be targeted with prophylaxis.

Key Words: Atrial Fibrillation • Coronary Artery • Bypass Grafting • Arrhythmia

This article has been cited by other articles:

				M. Sakabe, A. Shiroshita-Takeshita, A. Maguy, B. J.J.M. Brundel, A. Fujiki, H. Inoue, and S. Nattel Effects of a heat shock protein inducer on the atrial fibrillation substrate caused by acute atrial ischaemia Cardiovasc Res, April 1, 2008; 78(1): 63 - 70. [Abstract] [Full Text] [PDF]

				L. Rivard, H. Sinno, A. Shiroshita-Takeshita, G. Schram, T.-K. Leung, and S. Nattel The pharmacological response of ischemia-related atrial fibrillation in dogs: Evidence for substrate-specific efficacy Cardiovasc Res, April 1, 2007; 74(1): 104 - 113. [Abstract] [Full Text] [PDF]

				J. Melo, P. Voigt, B. Sonmez, M. Ferreira, M. Abecasis, M. Rebocho, A. Timoteo, C. Aguiar, S. Tansal, H. Arbatli, et al. Ventral cardiac denervation reduces the incidence of atrial fibrillation after coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 511 - 516. [Abstract] [Full Text] [PDF]

				H. Sinno, K. Derakhchan, D. Libersan, Y. Merhi, T. K. Leung, and S. Nattel Atrial Ischemia Promotes Atrial Fibrillation in Dogs Circulation, April 15, 2003; 107(14): 1930 - 1936. [Abstract] [Full Text] [PDF]