The impact of postoperative atrial fibrillation on neurocognitive outcome after coronary artery bypass graft surgery.

Published

Journal Article

UNLABELLED: Neurocognitive decline is a continuing source of morbidity after cardiac surgery. Atrial fibrillation occurs often after cardiac surgery and has been linked to adverse neurologic events. We sought to determine whether postoperative atrial fibrillation was associated with postoperative cognitive dysfunction. Four-hundred-eleven patients were enrolled to receive a battery of neurocognitive tests both preoperatively and 6 wk after elective coronary artery bypass graft surgery. Neurocognitive test scores were separated into four cognitive domains, with a composite cognitive index (the mean of the four domain scores) determined for each patient at every testing period. Multivariable analysis controlling for age, years of education, diabetes mellitus, left ventricular ejection fraction, and preoperative atrial fibrillation compared the presence of postoperative atrial fibrillation with change in cognitive function. Three-hundred-eight patients completed both pre- and postoperative cognitive testing; 69 patients (22%) had postoperative atrial fibrillation. Those who developed atrial fibrillation showed more cognitive decline than those who did not develop postoperative atrial fibrillation (P = 0.036). Atrial fibrillation was associated with poorer cognitive function 6 wk after surgery. Although the mechanism of this association is yet to be determined, prevention of atrial fibrillation may result in improved neurocognitive function. IMPLICATIONS: Neurocognitive dysfunction is common after coronary artery bypass graft surgery. The relationship between atrial fibrillation and neurocognitive dysfunction has not been examined. Our study shows that postoperative atrial fibrillation is associated with neurocognitive decline.

Full Text

Duke Authors

Cited Authors

  • Stanley, TO; Mackensen, GB; Grocott, HP; White, WD; Blumenthal, JA; Laskowitz, DT; Landolfo, KP; Reves, JG; Mathew, JP; Newman, MF; Neurological Outcome Research Group, ; CARE Investigators of the Duke Heart Center,

Published Date

  • February 2002

Published In

Volume / Issue

  • 94 / 2

Start / End Page

  • 290 - 295

PubMed ID

  • 11812686

Pubmed Central ID

  • 11812686

International Standard Serial Number (ISSN)

  • 0003-2999

Digital Object Identifier (DOI)

  • 10.1097/00000539-200202000-00011

Language

  • eng

Conference Location

  • United States