The Value of Left Atrial Strain and Strain Rate for Prediction of Early Postoperative Atrial Fibrillation Following Isolated Off-Pump Coronary Artery Bypass Grafting in Low-Risk Patients Publisher Pubmed



Bigdelu L ; Azari A ; Maadarani O ; Bakefayat S ; Ebrahimi N ; Emadzadeh M
Source: Annals of Noninvasive Electrocardiology Published:2026

Abstract

Background: Following coronary artery bypass grafting (CABG) surgery, postoperative atrial fibrillation (POAF) is a prevalent arrhythmia. Prior research has demonstrated a paucity of reliable approaches to predict early POAF after CABG, particularly in low-risk subjects. The present investigation proposed to assess how effectively left atrial (LA) strain and LA strain rate predict early POAF after isolated off-pump CABG (OPCAB) in low-risk individuals. Methods: One hundred and twenty-three low-risk subjects with sinus rhythm who underwent isolated OPCAB were assessed in this prospective research. The velocity vector imaging (VVI) method was utilized to measure LA strain and LA strain rate. Subsequently, the patients were monitored post-surgery for 1 week to assess whether early POAF had occurred. Results: In contrast to those who did not experience early POAF, individuals with early POAF showed significantly lower LA strain (21.25 vs. 37.59, p < 0.001), lower LA strain rate (1.37 vs. 2.73, p < 0.001), and higher left atrial volume index (LAVI) (p < 0.001). A 1-unit increase in LA strain was associated with a 33% decrease in the odds of early POAF (OR = 0.67, 95% CI: 0.50–0.89; p = 0.006). Conclusion: Preoperative left atrial strain measurements may serve as an effective predictor of early POAF in low-risk patients after isolated OPCAB. Rather than treating all patients undergoing CABG, identifying the group at greater risk for early POAF may enable targeted prophylactic therapy. © 2026 The Author(s). Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC.