| Title: | Predictive value of heart rate variability for postoperative atrial fibrillation in off-pump coronary artery bypass patients |
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| Authors: | ID Kšela, Juš (Author)
ID Kafol, Jan (Author)
ID Avbelj, Viktor (Author)
ID Kališnik, Jurij-Matija (Author) |
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| Files: |  PDF - Presentation file, download (881,19 KB)
MD5: 1D6866B38B6AE7FD36886715F3353359
 URL - Source URL, visit https://www.mdpi.com/1648-9144/61/6/984
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| Language: | English |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  UKC LJ - Ljubljana University Medical Centre
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| Abstract: | 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. |
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| Keywords: | DFA Alpha 1, atrial fibrillation, coronary artery bypass grafting, heart rate variability |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2025 |
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| Number of pages: | str. 1-12 |
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| Numbering: | Vol. 61, issue 6, [article no.] 984 |
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| PID: | 20.500.12556/DiRROS-24710  |
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| UDC: | 616.1 |
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| ISSN on article: | 1648-9144 |
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| DOI: | 10.3390/medicina61060984 |
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| COBISS.SI-ID: | 257025795 |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 13. 11. 2025;
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| Publication date in DiRROS: | 15.12.2025 |
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| Views: | 10 |
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| Downloads: | 6 |
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