PREDICTING FACTORS OF ATRIAL FIBRILLATION IN PATIENTS
UNDERGOING CORONARY ARTERY BYPASS GRAFTING
Nopparat Opasvipada11,*, Tipa Toskulkao22, Orapan Thosingha33,
Kessiri Wongkongkam44,Worawong Slisatkorn55#
1
Faculty of Nursing, Mahidol University Thailand
2
Ph.D., Faculty of Nursing, Mahidol University, Bangkok, Thailand
3
D.N.S, Faculty of Nursing, Mahidol University, Bangkok Thailand
4
Ph.D. (Nursing)., Faculty of Nursing, Mahidol University, Bangkok, Thailand
5
M.D. Department of Cardio-Vascular Thoracic Surgery, Faculty of Medicine Siriraj
Hospital, Mahidol University, Bangkok, Thailand
*
e-mail: nopparat_tt_ pare@hotmail.com, #e-mail: tipa.tos@mahidol.ac.th,
orapan.tho@mahidol.ac.th, nskessiri@mahidol.ac.th, siwsl@mahidol.ac.th,
Abstract
This research studied the predictive power of Magnesium serum, pain, systematic
inflammatory response syndrome (SIRS) on Atrial Fibrillation (AF) among patients
undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).
The sample comprised 90 adult patients who were admitted to a university hospital in
Bangkok. Data collection was conducted from October 2012 to March 2013. Logistic
Regression Analysis was employed for data analysis with a significance level of less than
0.05.
The results revealed that the incidence of AF among patients undergoing CABG was
37.8% and 38.2 % of AF occurred on the first day post operation. The majority of patients
who demonstrated AF were male (67.6%) with the average age of 69.5 years ( SD ± 9.5
years). Almost all patients in this study suffered with several chronic illnesses and 86.7 % of
them had hypertension.
The occurrence of AF was neither associated with level of magnesium nor level of pain
(p = .74 and p = .72, respectively) while it was associated with SIRS ( p = .04). Moreover,
SIRS which occurred within the first 24 hours after CABG can predict the occurrence of
postoperative AF (OR 2.71; 95% CI 1.03 – 7.16, p = 0.04).
This study supports that the view that AF is a critical complication among patients
undergoing CABG with CPB. Its occurrence is relatively high (1 out of 3), so nurses should
take this problem into serious consideration. In addition to regular vital sign monitoring, it is
recommended that within 24 to 72 hours after receiving CABG with CPB, patients should be
closely monitored for SIRS because it can lead to AF. It is expected that if SIRS can be
detected early, nurses can effectively prevent the occurrence of AF.
Keywords: coronary artery bypass grafting (CABG)1, systematic inflammatory response
sysdrome (SIRS)2, atrial fibrillation (AF)3, serum magnesium4 , pain5,