Prediction of new atrial fibrillation after off-pump coronary artery bypass grafting based on preoperative heart rate variability: A retrospective study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Yang , YIN Zongtao , JIANG Hui , TAO Dengshun , ZHAO Keyan , ZHANG Jian , XIN Fangran , LAN Huai , ZHANG Wei ,  WANG Huishan

Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P. R. China;

Corresponding author：

WANG Huishan, Email: huishanw@126.com

Keywords：

Heart rate variability; off-pump coronary artery bypass grafting; postoperative atrial fibrillation

DOI：

10.7507/1007-4848.202204075

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To study the relationship between preoperative heart rate variability (HRV) and postoperative atrial fibrillation (POAF) after off-pump coronary artery bypass grafting (OPCAB). Methods A retrospective analysis was performed on the clinical data of 290 patients who were admitted to the Department of Cardiovascular Surgery, General Hospital of Northern Theater Command from May to September 2020 and received OPCAB. There were 217 males and 73 females aged 36-80 years. According to the incidence of POAF, the patients were divided into two groups: a non-atrial fibrillation group (208 patients) and an atrial fibrillation group (82 patients). The time domain and frequency domain factors of mean HRV 7 days before operation were calculated: standard deviation of all normal-to-normal intervals (SDNN), root mean square of successive differences, percentage difference between adjacent normal-to-normal intervals that were greater than 50 ms, low frequency power (LF), high frequency power (HF), LF/HF. Results The HRV value of patients without POAF was significantly lower than that of patients with POAF (P<0.05). The median SDNN of the two groups were 78.90 ms and 91.55 ms, respectively. Age (OR=3.630, 95%CI 2.015-6.542, P<0.001), left atrial diameter (OR=1.074, 95%CI 1.000-1.155, P=0.046), and SDNN (OR=1.017, 95%CI 1.002-1.032, P=0.024) were independently associated with the risk of POPAF after OPCAB. Conclusion SDNN may be an independent predictor of POAF after OPCAB.

Citation： WANG Yang, YIN Zongtao, JIANG Hui, TAO Dengshun, ZHAO Keyan, ZHANG Jian, XIN Fangran, LAN Huai, ZHANG Wei, WANG Huishan. Prediction of new atrial fibrillation after off-pump coronary artery bypass grafting based on preoperative heart rate variability: A retrospective study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(1): 121-125. doi: 10.7507/1007-4848.202204075 Copy

1.	Filardo G, Damiano RJ, Ailawadi G, et al. Epidemiology of new-onset atrial fibrillation following coronary artery bypass graft surgery. Heart, 2018, 104(12): 985-992.
2.	Taha A, Nielsen SJ, Bergfeldt L, et al. New-onset atrial fibrillation after coronary artery bypass grafting and long-term outcome: A population-based nationwide study from the SWEDEHEART Registry. J Am Heart Assoc, 2021, 10(1): e017966.
3.	Vuoti AO, Tulppo MP, Ukkola OH, et al. Prognostic value of heart rate variability in patients with coronary artery disease in the current treatment era. PLoS One, 2021, 16(7): e0254107.
4.	Escorihuela RM, Capdevila L, Castro JR, et al. Reduced heart rate variability predicts fatigue severity in individuals with chronic fatigue syndrome/myalgic encephalomyelitis. J Transl Med, 2020, 18(1): 4.
5.	Endukuru CK, Gaur GS, Yerrabelli D, et al. Impaired baroreflex sensitivity and cardiac autonomic functions are associated with cardiovascular disease risk factors among patients with metabolic syndrome in a tertiary care teaching hospital of South-India. Diabetes Metab Syndr, 2020, 14(6): 2043-2051.
6.	Messerli FH, Hofstetter L, Rimoldi SF, et al. Risk factor variability and cardiovascular outcome: JACC review topic of the week. J Am Coll Cardiol, 2019, 73(20): 2596-2603.
7.	Souza HCD, Philbois SV, Veiga AC, et al. Heart rate variability and cardiovascular fitness: What we know so far. Vasc Health Risk Manag, 2021, 17: 701-711.
8.	中国研究型医院协会, 中国医师协会房颤专家委员会. 心房颤动外科治疗中国专家共识2020版. 中华胸心血管外科杂志, 2021, 37(3): 129-144.
9.	Ardell JL, Andresen MC, Armour JA, et al. Translational neurocardiology: Preclinical models and cardioneural integrative aspects. J Physiol, 2016, 594(14): 3877-3909.
10.	Ishaque S, Khan N, Krishnan S. Trends in heart-rate variability signal analysis. Front Digit Health, 2021, 3: 639444.
11.	Khan AA, Lip GYH, Shantsila A. Heart rate variability in atrial fibrillation: The balance between sympathetic and parasympathetic nervous system. Eur J Clin Invest, 2019, 49(11): e13174.
12.	Tiwari R, Kumar R, Malik S, et al. Analysis of heart rate variability and implication of different factors on heart rate variability. Curr Cardiol Rev, 2021, 17(5): e160721189770.
13.	Stavrakis S, Stoner JA, Humphrey MB, et al. TREAT AF (Transcutaneous Electrical Vagus Nerve Stimulation to Suppress Atrial Fibrillation): A randomized clinical trial. JACC Clin Electrophysiol, 2020, 6(3): 282-291.
14.	Stavrakis S, Humphrey MB, Scherlag BJ, et al. Low-level transcutaneous electrical vagus nerve stimulation suppresses atrial fibrillation. J Am Coll Cardiol, 2015, 65(9): 867-875.
15.	Kinoshita T, Asai T, Ishigaki T, et al. Preoperative heart rate variability predicts atrial fibrillation after coronary bypass grafting. Ann Thorac Surg, 2011, 91(4): 1176-1181.
16.	Chamchad D, Djaiani G, Jung HJ, et al. Nonlinear heart rate variability analysis may predict atrial fibrillation after coronary artery bypass grafting. Anesth Analg, 2006, 103(5): 1109-1112.

1. Filardo G, Damiano RJ, Ailawadi G, et al. Epidemiology of new-onset atrial fibrillation following coronary artery bypass graft surgery. Heart, 2018, 104(12): 985-992.
2. Taha A, Nielsen SJ, Bergfeldt L, et al. New-onset atrial fibrillation after coronary artery bypass grafting and long-term outcome: A population-based nationwide study from the SWEDEHEART Registry. J Am Heart Assoc, 2021, 10(1): e017966.
3. Vuoti AO, Tulppo MP, Ukkola OH, et al. Prognostic value of heart rate variability in patients with coronary artery disease in the current treatment era. PLoS One, 2021, 16(7): e0254107.
4. Escorihuela RM, Capdevila L, Castro JR, et al. Reduced heart rate variability predicts fatigue severity in individuals with chronic fatigue syndrome/myalgic encephalomyelitis. J Transl Med, 2020, 18(1): 4.
5. Endukuru CK, Gaur GS, Yerrabelli D, et al. Impaired baroreflex sensitivity and cardiac autonomic functions are associated with cardiovascular disease risk factors among patients with metabolic syndrome in a tertiary care teaching hospital of South-India. Diabetes Metab Syndr, 2020, 14(6): 2043-2051.
6. Messerli FH, Hofstetter L, Rimoldi SF, et al. Risk factor variability and cardiovascular outcome: JACC review topic of the week. J Am Coll Cardiol, 2019, 73(20): 2596-2603.
7. Souza HCD, Philbois SV, Veiga AC, et al. Heart rate variability and cardiovascular fitness: What we know so far. Vasc Health Risk Manag, 2021, 17: 701-711.
8. 中国研究型医院协会, 中国医师协会房颤专家委员会. 心房颤动外科治疗中国专家共识2020版. 中华胸心血管外科杂志, 2021, 37(3): 129-144.
9. Ardell JL, Andresen MC, Armour JA, et al. Translational neurocardiology: Preclinical models and cardioneural integrative aspects. J Physiol, 2016, 594(14): 3877-3909.
10. Ishaque S, Khan N, Krishnan S. Trends in heart-rate variability signal analysis. Front Digit Health, 2021, 3: 639444.
11. Khan AA, Lip GYH, Shantsila A. Heart rate variability in atrial fibrillation: The balance between sympathetic and parasympathetic nervous system. Eur J Clin Invest, 2019, 49(11): e13174.
12. Tiwari R, Kumar R, Malik S, et al. Analysis of heart rate variability and implication of different factors on heart rate variability. Curr Cardiol Rev, 2021, 17(5): e160721189770.
13. Stavrakis S, Stoner JA, Humphrey MB, et al. TREAT AF (Transcutaneous Electrical Vagus Nerve Stimulation to Suppress Atrial Fibrillation): A randomized clinical trial. JACC Clin Electrophysiol, 2020, 6(3): 282-291.
14. Stavrakis S, Humphrey MB, Scherlag BJ, et al. Low-level transcutaneous electrical vagus nerve stimulation suppresses atrial fibrillation. J Am Coll Cardiol, 2015, 65(9): 867-875.
15. Kinoshita T, Asai T, Ishigaki T, et al. Preoperative heart rate variability predicts atrial fibrillation after coronary bypass grafting. Ann Thorac Surg, 2011, 91(4): 1176-1181.
16. Chamchad D, Djaiani G, Jung HJ, et al. Nonlinear heart rate variability analysis may predict atrial fibrillation after coronary artery bypass grafting. Anesth Analg, 2006, 103(5): 1109-1112.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Prediction of new atrial fibrillation after off-pump coronary artery bypass grafting based on preoperative heart rate variability: A retrospective study

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