Background: Postoperative atrial fibrillation (POAF) occurs in 10% - 65% of patients undergoing cardiac surgery and is the most common arrhythmia in practice. This study aims to know which of the left atrial (LA) parameters available can predict its occurrence.
Method: Adult patients who underwent cardiac surgery with preoperative LA parameters (2 dimensional and 3D) for analysis at Philippine Heart (enter from July-December 2012 were included. The echocardiography clips were stored in the Non-invasive Diagnostic Laboratory Workplace (SC2000) and were analyzed by an independent, blinded observer. The subjects were hooked to telemetry and followed up for 3 days post-surgery for the occurrence of atrial fibrillation.
Results: Of the 57 patients included, 16 had POAF. Patients who developed POAF were older (p-value 0.014), had higher serum potassium (p-value 0.022) and lower left ventricular ejection fraction (p-value 0.028). Mitral E/E' and volume index (LAVI) by 2D and 3D were higher (p-value 0.007, 0.000, 0.000 respectively). Left atrial strain (LAS), strain rate (LASR), and ejection fraction (LAEF) by 3D and velocity vector integral (VVI) were lower (p-value 0.001, 0.000, 0.028, 0.011 respectively). Anteroposterior LA size is not associated with POAF(p-value 0.147).
Conclusion: The incidence of POAF is 28%. Higher mitral E/E', LAVI and lower LAS, LASR, LAEF are significantly associated with the development of POAF. Anteroposterior LA diameter is not associated with POAF.