Postoperative Atrial Fibrillation Following Isolated Coronary Artery Bypass Grafting: Incidence, Predictors, and Clinical Outcomes

OBJECTIVE: To investigate the incidence of postoperative atrial fibrillation (POAF) in patients following isolated coronary artery bypass grafting (CABG), evaluate its impact on mortality and morbidity, and analyse demographic and comorbid variables associated with its onset. STUDY DESIGN: Observational cohort study. Place and Duration of the Study: Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye, from June 2020 to December 2022. METHODOLOGY: Patients who underwent isolated CABG were included in the study. Those diagnosed with valvular heart disease on echocardiography were excluded, as were those with a history of atrial fibrillation (AF). RESULTS: Statistical analysis was conducted on data from 489 patients. Among the demographic factors examined, only age (p = 0.021) exhibited a significant correlation with the development of POAF. Chronic renal disease (p = 0.044) and reduced glomerular filtration rate (GFR) levels (p = 0.020) were significantly associated with POAF. Regarding perioperative factors, cardiopulmonary bypass (CPB) duration (p = 0.104) was not significantly related to POAF, whereas prolonged cross-clamp time was (p = 0.009). POAF was associated with postoperative complications, including acute kidney damage (p = 0.002), extended intubation (p = 0.003), infection (p <0.001), the need for intra-aortic balloon pump (IABP) or inotropic support (p = 0.004), and mortality (p = 0.001). CONCLUSION: POAF is a common complication after isolated CABG and is significantly associated with advanced age, reduced GFR, chronic kidney disease, and prolonged cross-clamp time. Its occurrence is associated with increased postoperative morbidity and mortality. These findings emphasise the importance of perioperative risk factors in predicting adverse outcomes. KEY WORDS: Atrial fibrillation, Coronary artery bypass, Acute kidney injury, Mortality, Morbidity, Intra-aortic balloon pumping.