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Predicting Atrial Fibrillation After CABG

Postoperative atrial fibrillation (AF) occurs in 15% to 30% of patients who undergo isolated CABG. Patients who develop AF after these procedures are at risk for longer hospital stay, perioperative morbidity and mortality, and long-term mortality. Identifying specific patients who are at high risk for developing AF after CABG may help define a population that is more likely to benefit from antiarrhythmic drugs or other AF prevention strategies. Evaluating a Simple AF Risk Model Previous analyses of patients undergoing CABG have suggested that certain preoperative, intraoperative, and postoperative factors can be used to determine the risk of postoperative AF (POAF), but these models can be cumbersome to apply and may not always be useful. In the American Journal of Cardiology, my colleagues and I had a study published that tested a simplified clinical tool using preoperative patient characteristics to identify those at high risk for POAF following CABG. Using the Society of Thoracic Surgery database, we identified a subset of preoperative variables that predispose patients to POAF. Using these variables, we created a risk index that had a moderate prediction power to identify patients at high risk of developing POAF. Patients were assigned point values according to the AF Risk Index Table. Patients scoring 4 points on the AF risk index had a 30% to 40% chance of developing POAF. Conversely, those with a score of 0 points had a less than 10% risk. “Identifying specific patients who are at high risk for developing AF after CABG may help define a population that is more likely to benefit from anti-arrhythmic drugs or other AF prevention strategies.” Mikhael F. El-Chami, MD...
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