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Value of the P-wave signal averaging electrocardiogram for predicting atrial fibrillation in early and long period after coronary artery bypass surgery

Paweł Ptaszyński, Jan Ruta, Krzysztof Kaczmarek, Ryszard Jaszewski, Janusz Zasłonka, Alicja Iwaszkiewicz-Zasłonka, Jan H Goch, Halina Bolińska

Med Sci Tech 2006; 47(2): RA105-108

ID: 881503

Introduction. Atrial fibrillation (AF) occurs commonly after coronary artery bypass surgery(CABG).Signal average dP-w ave ECG (A-SAECG) has been used to assess the risk of paroxysmal atrial fibrillation.The aim of this study was to define the clinical value of prolonged P-wave durationon A-SAECG for the prediction of atrial fibrillation after coronary artery bypass surgery. Materials and methods: 170 consecutive patients undergoing isolated CABG were enrolled to the study. Signal averaged ECG was recorded in all patients 1-14 days before CABG. Filtered P wave triggered QRS complex averaging at noise level <0.3 μV was analyzed. Information on their clinical surgical, and hemodynamic characteristics as well as hospital course was also collected. Results: During a follow-up period of up to 360 days, 28 patients (17%) developed AF 2,4+2.5 days (range 1 to 8 days) after surgery. Patients who developed AF were significantly older (60.1vs.57.6years, P<0.001). P wave duration on SAECG was significantly longer in group with postoperative AF (130+11 vs. 116+10 ms). Stepwise logistic regression analysis of preoperative variables identified that only prolonged P wave duration > 125ms (OR 4,23; 95% CI, 1,13-12,6; p<0,0001) independently predicted early postoperative AF. Prospectively defined P wave duration on SAECG >125 ms predicted AF with positive of 57% and negative predictive value of 93%, respectively. Conclusions: Prolonged P wave duration on SAECG >125 ms and combination of prolonged P wave duration >125 ms and age > 60 years good identifies patients at high risk for development of AF early after CABG.(Clin. Exp. Med. Lett. 2006; 47(2):105-108)

Keywords: Atrial Fibrillation, Arrhythmia, Surgery, PwavesignalaveragedECG

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