Predictability of Atrial Fibrillation in Patients having Coronary Artery Bypass Graft Surgery, Based on Selvester Score

Abstract

Aim: Patients having coronary artery bypass graft (CABG) surgery are influenced mostly by atrial fibrillation (AF), with the peak incidence of 16-44%. Due to post-operative AF (POAF), patients may be hospitalized for longer periods, require intensive care unit care again, necessitate more healthcare resources and even undergo congestive heart failure or stroke. Recent studies have shown that the size of the ventricular scar might be used as an indicator in the pathophysiology of AF. Selvester score was developed for the measurement of myocardial scar volume in patients with abnormal ventricular conduction, reporting its prognostic value in AF. Thus, we aim to investigate a likely relationship of POAF and the Selvester scoring system. Materials and Methods: This retrospective study included 180 patients with CABG from 2017 August to 2018 September. The obtained data had been analyzed in separate cohort of patients with POAF (n=50) and with post-operative sinus rhythm (PSR) (n=130). Intergroup comparisons were made using Selvester scores in particular. Results: The POAF group had higher Selvester scores (p<0.001), score of SYNTAX (p=0.039), serum high-sensitivity C-reactive protein levels (p=0.026), mean age (p<0.001), hypertrophy of left ventricul (LVH) (p=0.019) and hypertension (p=0.007) and decrased ejection fraction (LVEF) (p<0.001) than the PSR group. Logistic multivariable regression analyses showed that there were an independent association of LVH (p=0.041), LVEF (p=0.004), older age (p=0.008) and higher Selvester score (p<0.001) with POAF. Conclusion: Higher scores in Selvester scoring system are closely related to POAF, and Selvester score is a potential indicator for POAF.