Case-control study on atrial electromechanical coupling time in patients with new-onset postoperative atrial fibrillation.

Atrial electromechanical coupling time (AEMCT) can be used to evaluate atrial electrical remodeling and early structural remodeling. This study explores the predictive role of AEMCT in postoperative new-onset AF (POAF) after off-pump isolated coronary artery bypass grafting (OPCAB). A total of 116 patients who underwent OPCAB and left atrial diameter (LAD)<44 mm were analyzed. According to 7-day continuous telemetry and Holter monitoring after OPCAB, the patients were divided into POAF group and non- POAF group. Patients were divided into two groups according to whether new-onset POAF occurred, namely, POAF group (38, 32.7%) and non-POAF group (78, 67.3%). There was no significant difference in LAD between two group. Multivariate analysis found that P-ALA ( P wave on ECG to the starting point of A´wave on tissue Doppler imaging (TDI) spectrum at the left atrial lateral wall of the mitral annulus), TLA (AEMCT in the left atrium) and HbA1c (glycosylated hemoglobin) in POAF group were significantly higher than that in non-POAF group, that is, higher HbA1c, prolonged P-ALA and TLA were independent risk factors for POAF after OPCAB. P-ALA had the highest diagnostic predicting value. The AUC of HbA1c, P-ALA and TLA with Cut -off was 0.766, 95% CI: 0.67-0.86, P < 0.001. In OPCAB patients without significant LAD enlargement, when P-ALA ≥ 96. 50 ms, there is more than 90% probability of POAF. The combination of HbA1c, P-ALA and TLA has the highest predictive value of POAF. AEMCT measured with TDI has the advantages of low cost and high repeatability.Clinical Trial Registry Registration Number: ChiCTR2200056127.