Role of P wave dispersion using to estimate evaluate of atrial fibrillation in postoperative patients who are not using beta blockers and recommended to have cabg surgery

Coronary artery disease (CAD) is an independent risk factor for atrial fibrillation (AF) and AF is more frequent in patients with CAD. AF is seen more frequently in patients with acute coronary syndrome as well as in stable CAD. P wave dispersion is defined as the difference between the minimum and maximum p wave durations. Prolonged p wave duration and increased p wave dispersion is associated with increased AF risk. Beta blockers are main drugs in the treatment of acute and chronic ischemic heart disease. They are one of the most important agents, that are used in solving the rhythm problems with their antiarrhytmic properties. P wave dispersion are reduced by beta blocker agents, that do not use in KIHD patients with increasing p wave dispersion (PWD) AF prevision and confirm the antiischemic and antiarrhytmic effectiveness of beta blockers. For the reason ,we wanted to investigate that, post CABG surgery atrial fibrillation development and to evaluate PWD can be used to estimate the development of atrial fibrillation in postoperative patients who are not using beta blockers and recommended to have CABG surgery. AIM: To study the relationship of electrocardiographic parameters such as Pmax, Pmin, PDD, that can be obtained in a noninvasive manner, with post CABG surgery atrial fibrillation development and to evaluate whether these parameters can be used to estimate the development of atrial fibrillation in postoperative patients who are not using beta blockers and recommended to have CABG surgery. METHOD: 100 patients, that are between ages of 35-75, not using beta blockers, with stable coronary artery disease, stable cardiac status, without arythmia and recommended to have a CABG surgery after coronary angiography, are included in the study. The preoperative ECGs of the patients are obtained from patient files and the condition of ability to measure the electrocardiographic parameters in least 9 of the 12 leads is looked for. All the measurements are done manually with a looking glass. The patients are divided into two groups according to postoperative atrial fibrillation development. Present risk factors, involved coronary arteries, haemoglobin, haematocrit, MCV, MCH, MPV, cholesterol, fasting blood glucose, HbA1c levels, echocardiographic parameters (LA, RA, LVEDD, LVESD, MR), preoperative-peroperative-postoperative CVA history and which coronary arteries are involved significantly are recorded. RESULTS: Ages of the patients are between 35-75 (mean 64,2±7,9), 14 are female (14%) and 86 are male (86%). 67 patients (67%) has hypertension,46 (46%) has DM, 40 (40%) has hyperlipidemia. The difference between Pmax and Pmin values that are obtained from preoperative ECGs of the patients are found to be greater in the patients that experienced postoperative atrial fibrillation. CONCLUSION: Increased preoperative P wave dispersion is shown to be associated with increased early postoperative atrial fibrillation development.