الفهرس 
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Abstract
Postoperative atrial fibrillation is a major complication following coronary artery bypass graft surgery which occurs in 20% to 40% of patients. POAF leads to prolonged hospitalization and may have an impact on patients` morbidity leading to more resource utilization. Therefore, more attention has been paid to the prevention of AF in high-risk patients.
The aim of this study was to identify the predictors that may help in specifying patients vulnerable for this arrhythmia which allow targeting of the most likely who will benefit from prophylactic therapy.
Our study was conducted on 100 patients who underwent coronary artery bypass graft surgery in Alexandria university main hospital. Full history taking and laboratory investigation, 12 lead ECG and pre and postoperative echocardiography and preoperative angiographic data and full operative data were recorded for all patients and post-operative AF was defined as any sustained episode (>10minute) of atrial fibrillation from the time of the surgery to the time of discharge not exceeding 5 days.
We excluded patients with previous history of atrial fibrillation, patient taking antiarrthymic drugs except for B blockers, redo surgeries, off pump surgery, patients who had congestive heart failure and emergency surgeries.
Our study involved 100 consecutive patients who underwent coronary artery bypass graft surgery among which 82 patients (82%) did not develop post-operative AF and 18 patients (18%) developed post-operative AF.
Patients who developed POAF were older ( 67yrs vs 60yrs) p=<0.001, with higher body mass index (34.5kg/m2 vs 28 kg/m2) p= 0.012. The number of dyslipidemic patients who developed POAF was 16 (88%) meanwhile, the number of the dyslipidemic patients who didn’t develop POAF was 18 (22%) which was statistically significant p=<0.001.
Regarding ECG findings we found that patients who developed POAF had signs of left atrial enlargement on surface ECG (p=0.003), prolonged PR interval (p=<0.001).
We found, regarding echocardiographic findings that patients who developed POAF had Lower left ventricular ejection fraction (49% vs 60%) p= 0.016, grade II diastolic dysfunction (p=0.002), high E/A ratio(p=0.048), high E/e’ ratio(p=0.032) and low e’ values(p=0.003) and also had higher left atrial volume index(39.91ml/m2 vs 28.22ml/m2 ) p=<0.001, larger Left atrium dimensions (41.5mm vs 38mm)(p=<0.001).
Regarding angiographic data preoperatively, we found that the number of patients with proximal RCA lesions who developed POAF compared to number of patients who didn’t develop POAF was statistically significant (p=0.004).
According to operative Data records, we noted that prolonged aortic cross clamp time was statistically significant (p=0.014).
According to laboratory investigations we noted that patients who developed POAF had Low level of serum calcium p=<0.001 and higher level of WBCs