Analysis of predictors of sick sinus syndrome after open surgical treatment of atrial fibrillation

Aim. To identify and analyze predictors of the development of sick sinus syndrome in patients with atrial fibrillation.

Material and methods. We include 847 patients with paroxysmal (121) and permanent (726) form of atrial fibrillation in our research. Patients underwent the Cox-Maze IV procedure with correction of valvular and/or coronary pathology in the conditions of artificial blood circulation. The volume of surgical intervention, clinical, laboratory and echocardiographic parameters were considered as independent predictors.

Results. Permanent pacemaker implantation at the hospital stage required 37 (4.3%) from all 847 patients. None of these patients had indications for permanent pacemaker implantation before the intervention. Indications for pacemaker implantation: sick sinus syndrome – in 30 (3.5%), bradiarrhythmia – in 6 (0.7%); Frederick’s syndrome – in 1 (0.11%) patient. Sinus node weakness syndrome is the most common reason for installing permanent pacemaker. Analysis of neural networks showed that body mass index, time of cardiopulmonary bypass, time of mechanical ventilation, and the age of the patient are independent predictors of the development of this condition.

Conclusion. Obesity, time of cardiopulmonary bypass, time of mechanical ventilation, and age of the patient are the independent and most significant predictors of the development of sick sinus syndrome.