20.500.12556/DiRROS-24710 Predictive value of heart rate variability for postoperative atrial fibrillation in off-pump coronary artery bypass patients Background and Objectives: Postoperative atrial fibrillation (AF) is a frequent complication after coronary artery bypass grafting (CABG), and is particularly associated with poor outcomes. Heart rate variability (HRV), a non-invasive marker of autonomic function, has been proposed as a tool to predict AF risk, but its utility in off-pump CABG remains unclear. This study aimed to evaluate the predictive value of preoperative HRV parameters, including nonlinear metrics, for postoperative AF in patients undergoing off-pump CABG. Materials and Methods: We prospectively enrolled 67 patients undergoing elective off-pump CABG. HRV was assessed using 15 min high-resolution ECGs. Linear and nonlinear HRV parameters were analyzed. Postoperative AF was monitored through continuous ECG (days 0–4), daily 12-lead ECGs (days 5–7), and a 24 h Holter ECG on day 7. Statistical comparisons between AF and non-AF groups were performed, and the predictive accuracy was evaluated using ROC analysis. Results: Postoperative AF occurred in 40.3% (n = 27) of patients. Standard HRV measures (total power, frequency components, LF/HF ratio) did not differ significantly between groups. However, preoperative DFA Alpha 1 was significantly lower in patients who developed AF (p = 0.010) and showed the highest predictive value (AUC = 0.725, specificity = 80%). Alpha 1 also remained significantly reduced postoperatively in the AF group. Other nonlinear parameters, such as low and average fractal dimension, were also lower postoperatively in the AF group. Conclusions: Traditional HRV parameters showed limited predictive value for postoperative AF following off-pump CABG. The nonlinear DFA Alpha 1 index demonstrated a moderate predictive performance and may serve as a useful marker of autonomic dysregulation. Incorporating nonlinear HRV measures into preoperative assessment may improve AF risk stratification. DFA Alpha 1 atrial fibrillation coronary artery bypass grafting heart rate variability DFA Alfa 1 atrijska fibrilacija operacija obvoda koronarne arterije variabilnost srčne frekvence true false true Angleški jezik Slovenski jezik Neznano 2025-12-15 11:14:41 2025-12-15 11:14:42 2025-12-16 03:44:28 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 13. 11. 2025; str. 1-12 issue 6, [article no.] 984 Vol. 61 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.1 1648-9144 10.3390/medicina61060984 257025795 RAZ_Ksela_Jus_2025.pdf RAZ_Ksela_Jus_2025.pdf 1 1D6866B38B6AE7FD36886715F3353359 7829419dc1c8145cb54d261607f8b209e993923fc1839639ad9641dd79f2aac3 10788701-d99f-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=36903 https://www.mdpi.com/1648-9144/61/6/984 0 3904692a-d99f-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=36904 Univerzitetni klinični center Ljubljana 0 0 0