Fragmented QRS complexes are associated with postoperative atrial fibrillation development after coronary artery bypass grafting surgery

Abstract

Objective 

Postoperative atrial fibrillation (PoAF) is one of the most frequent complications and a major risk factor of morbidity and mortality after coronary artery bypass grafting (CABG). Fragmented QRS complex (fQRS) on a 12-lead surface ECG is recently gained increasing attention as a simplified noninvasive ECG marker with diagnostic and prognostic value in various cardiac conditions. The aim of the present study was to evaluate the association between development of PoAF and presence of fQRS on admission ECG in patients undergoing CABG surgery.

Methods 

A total of 242 patients who underwent CABG between February 2016 and June 2018 were included in this study. The patients were divided into two groups as developing and nondeveloping PoAF groups in the postoperative period. fQRS was defined as the presence of various RSR′ patterns including an additional R wave, notching of the R or S waves, or the presence of more than one fragmentation in two contiguous leads.

Results 

In-hospital mortality was higher in PoAF (+) group compared to PoAF (–) group (20.5 vs. 6.4%, P = 0.004). PoAF rate was higher in fQRS (+) group than fQRS (–) group (25.3 vs. 9.8%, P = 0.001). In multivariate analysis, the presence of fQRS complexes on admission ECG [odds ratio (OR) 2.801, 95% confidence interval (CI) 1.262–6.211, P = 0.011) and hemoglobin (OR 0.794; 95% CI, 0.641–0.985; P = 0.036) were identified as independent predictors of PoAF after CABG surgery.

Conclusion 

The presence of fQRS on admission ECG was found to be an independent predictor of PoAF in patients undergoing isolated CABG.