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Persistently high incidence of postcoronary bypass atrial fibrillation: possible mechanisms
  1. Nazem Akoum
  1. Correspondence to Dr Nazem Akoum, Department of Cardiology, University of Washington, Seattle, WA 98105, USA; nakoum{at}cardiology.washington.edu

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Despite advances in surgical techniques, atrial fibrillation (AF) continues to be the most prevalent rhythm disorder after cardiac surgery, including coronary artery bypass grafting (CABG).1 Post-CABG AF typically presents between the second and third postoperative day. It is associated with adverse long-term outcomes including perioperative stroke, hospital length of stay and overall mortality.2 The prevalence of post-CABG AF has not significantly changed over the past two decades, despite advances in surgical techniques, and it continues to be the subject of ongoing research.

In their Heart manuscript, Filardo and colleagues report on the incidence of post-CABG AF using data collected from five high-volume surgical centres in the USA. The authors found that the unadjusted incidence of post-CABG AF was around 29.5% and 33.1% after adjustment for comorbidities captured using the Society for Thoracic Surgery score. The incidence of post-CABG AF did not significantly change over the study period which spanned from 2002 to 2010. The median time of onset of AF after CABG was 52 hours and the first episode lasted for an average of 7.2 hours.3

The study found some expected differences in the prevalence of cardiovascular comorbidities in patients who did and those who did not develop post-CABG AF. These …

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