P-wave indices: manifest atrial fibrillation after postoperative atrial fibrillation?

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Thoracic and Cardiovascular Surgeon Pub Date : 2025-05-20 DOI:10.1055/a-2616-3919

Christian Peter Erich Rau, Miriam Salzmann-Djufri, Andreas Böning, Susanne Rohrbach, Bernd Niemann

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引用次数: 0

Abstract

Objectives: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery. We investigated how POAF affects the manifestation of atrial fibrillation (AF) during long-term follow-up.

Methods: We conducted a prospective all-comers investigation involving patients undergoing cardiac surgery. In propensity score matched cohorts (POAF vs sinus rhythm), ECGs were evaluated regarding P-wave duration, amplitude, morphology, variability and their dynamics preoperatively pre-POAF and at follow-up. Predictive value of these parameters regarding development of manifest AF after POAF was analyzed.

Results: From 212 patients included, 50 patients (23.6 %) developed POAF. Ninety patients underwent PSM, 64 (71 %) participated in follow-up, 21 (23 %) died prior to follow up (POAF: 13 vs. SR: 8), and 5 (6 %) withdrew consent. No patient developed persistent AF. In 9 patients paroxysmal AF events were detected (POAF: 6 vs. SR: 3). P-wave duration, P-dispersion, P-amplitude and interatrial block differed between POAF and SR. From pre- to postoperative ECGs, P-dispersion and PWPT increased and P-amplitude decreased in these. Preoperative beta-blockers had only minor modulating potency. P-wave modulation was pronounced in POAF patients.

Conclusion: Patients with POAF are prone to episodes of paroxysmal AF. P-wave indices and perioperative dynamics of these indices may indicate a higher risk of manifest AF initiation among POAF patients.

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p波指标：术后房颤是否表现为房颤？

目的：术后心房颤动（POAF）是心脏手术后常见的并发症。我们在长期随访中研究了POAF如何影响心房颤动（AF）的表现。方法：我们对所有接受心脏手术的患者进行了前瞻性调查。在倾向评分匹配的队列中（POAF与窦性心律），对心电图进行评估，包括术前POAF前和随访时的p波持续时间、振幅、形态、变异性及其动态。分析这些参数对POAF后明显房颤发展的预测价值。结果：纳入的212例患者中，50例（23.6%）发生POAF。90例患者接受了PSM， 64例（71%）参加了随访，21例（23%）在随访前死亡（POAF: 13对SR: 8）， 5例（6%）撤回同意。没有患者发生持续性房颤。9例患者检测到阵发性房颤事件（POAF: 6 vs SR: 3）。p波持续时间、p -离散度、p -振幅和房间传导阻滞在POAF和sr之间存在差异。从术前和术后的心电图来看，POAF和sr的p -离散度和PWPT升高，p -振幅降低。术前-受体阻滞剂只有轻微的调节作用。POAF患者p波调制明显。结论：POAF患者易发生阵发性房颤，p波指数及其围手术期动态变化提示POAF患者发生明显房颤的风险较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thoracic and Cardiovascular Surgeon 医学-呼吸系统

CiteScore

3.40

自引率

6.70%

发文量

365

审稿时长

3 months

期刊介绍： The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field. Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.