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CARDIOVASCULAR ANESTHESIA

Nonlinear Heart Rate Variability Analysis May Predict Atrial Fibrillation After Coronary Artery Bypass Grafting

Dmitri Chamchad, MD^*, George Djaiani, MD, Hyun Ju Jung, MD, Lev Nakhamchik, MSc, Jo Carroll, RN, and Jay C. Horrow, MD, MS

From the *Department of Anesthesia, Lankenau Hospital, Wynnewood, Pennsylvania; Department of Anesthesia, Toronto General Hospital, Toronto, Ontario, Canada; and Department of Anesthesia, Drexel University College of Medicine, Philadelphia, Pennsylvania.

Address correspondence and reprint requests to Jay Horrow, MD, MS, Mail Stop 310, Broad and Vine, Philadelphia, PA 19102-1192. Address e-mail to jhorrow{at}drexelmed.edu.

BACKGROUND: Heart rate variability might predict arrhythmias after coronary artery bypass grafting.

METHODS: Off-line processing of 10-min electrocardiogram recordings of consecutive patients provided R–R intervals for time domain, frequency domain, Poincaré, and point correlation analyses and subsequent association with postoperative atrial fibrillation by stepwise multivariate logistic regression.

RESULTS: Of 88 patients who met entry criteria, 13 developed atrial fibrillation. Peak point correlation dimension (odds ratio 3.985/unit, P = 0.0096) and age (odds ratio 1.144/yr, P = 0.0019) were independently associated with atrial fibrillation (c-statistic = 0.839).

CONCLUSIONS: Further study should confirm the ability of peak point correlation dimension to predict atrial fibrillation after coronary artery surgery with cardiopulmonary bypass.

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