Comparative analysis of autonomic nervous function alterations and atrial fibrillation prediction following coronary artery bypass grafting and mitral valve surgery
ZHANG Yu-ji
YIN Zong-tao
XIN Fang-ran
LIU Guan-nan
LIU Huai-yang
WANG Hui-shan
Abstract：Objective To compare the changes in autonomic nervous function post-surgery between patients undergoing coronary artery bypass grafting(CABG)and mitral valve surgery(MVS),and to explore the predictive value of heart rate variability(HRV)indicators in postoperative atrial fibrillation(POAF).Methods A total of 548 patients who underwent CABG or mitral valve surgery and developed POAF in the cardiovascular surgery department of Northern Theater General Hospital from April 2020 to April 2022 were selected,including 380 males and 168 females,with an average age of(64.47±7.41)years,ranging from 32 to 80 years.Patients were divided into CABG group(n=431)and MVS group(n=117)based on the type of surgery.Holter monitoring was conducted continuously from 7 days before to 7 days after surgery to record and analyze HRV indicators,including low frequency(LF),high frequency(HF),low frequency/high frequency(LF/HF)ratio,standard deviation(SDNN),short-term heart rate variability(rMSSD),and pNN50.Results The CABG group showed significant differences in multiple HRV indicators compared to the MVS group,including HF(P=0.013),rMSSD(P=0.007),and pNN50(P=0.006).The HRV indicators in the CABG group exhibited significant dynamic changes over time,particularly a notable increase in LF and HF in the 30 minutes preceding the onset of atrial fibrillation.The HRV indicators in the MVS group fluctuated less,indicating a relatively stable recovery post-surgery.Conclusion The autonomic nervous function of patients post-CABG exhibits considerable fluctuations,particularly with characteristic changes prior to the occurrence of POAF,suggesting that HRV monitoring could serve as an effective tool for predicting POAF.The autonomic nervous function of patients undergoing mitral valve surgery is relatively stable,allowing for a corresponding simplification of postoperative monitoring strategies.
Keywords：Coronary artery bypass graftingMitral valve surgeryHeart rate variabilityPostoperative atrial fibrillationAutonomic nervous systemPrediction
Publication Date：2024-12-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 357-361 )