[Bayes' syndrome in cardiac surgery: prevalence of interatrial block in patients younger than 65 years undergoing cardiac surgery and association with postoperative atrial fibrillation]

Arch Cardiol Mex. 2018 Dec;88(5):369-375. doi: 10.1016/j.acmx.2017.09.004. Epub 2017 Nov 3.
[Article in Spanish]

Abstract

Objective: Interatrial block (IAB) is a well-known entity that is associated with an increased risk of atrial fibrillation (AF). This association is called Bayes' syndrome. The aim of our study was to define the prevalence of IAB among patients younger than 65 years undergoing cardiac surgery and determine whether there is an association between the presence of interatrial conduction delay and postoperative atrial fibrillation (POAF).

Method: A total of 207 patients were enrolled. Partial IAB was defined as P-wave>120ms. Advanced IAB was defined as P-wave>120ms+biphasic morphology in the inferior leads. Ocurrence of POAF was assessed and a comparative analysis was conducted between patients that did and did not develop AF.

Results: IAB prevalence was 78.3% (partial 66.2%, advanced 12.1%). POAF occurred in 28.5% of all patients, and was more frequent among patients with advanced IAB (44%) compared to 27.7% and 24.4% of POAF among patients with partial IAB and without IAB, respectively. Patients who developed POAF were significantly older, had significantly higher NTproBNP, higher prevalence of atrial enlargement and thyroid disease. After multivariate analysis, advanced IAB was found to be independently associated with POAF.

Conclusions: IAB is a frequent finding among patients undergoing cardiac surgery. According to our results, advanced IAB is independently associated with POAF in younger patients (<65 years) undergoing cardiac surgery.

Keywords: Atrial fibrillation; Bayes’ syndrome; Bloqueo interauricular; Cardiac surgery; Cirugía cardiaca; España; Fibrilación auricular; Fibrilación auricular postoperatoria; Interatrial block; Postoperative atrial fibrillation; Spain; Síndrome de Bayés.

MeSH terms

  • Adult
  • Age Factors
  • Atrial Fibrillation / epidemiology*
  • Atrial Fibrillation / etiology
  • Cardiac Surgical Procedures / methods*
  • Female
  • Humans
  • Interatrial Block / epidemiology*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Natriuretic Peptide, Brain / blood
  • Peptide Fragments / blood
  • Postoperative Complications / epidemiology*
  • Prevalence

Substances

  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain