Scoring system for predicting the Post-Operative Atrial Fibrillation (POAF) in post-cardiac surgery: a literature review

Abstract

Link of Video Abstract: https://youtu.be/tl9Q8g6DUdcBackground: Coronary artery bypass grafting (CABG) is still one of the optimal treatment options for revascularization in coronary heart disease. Despite Atrial Fibrillation being the most common arrhythmia after CABG, there’s still no agreement on which risk assessment to predict the incidence of Post Operative Atrial Fibrillation (POAF).  Some studies have shown that the findings of Atrial fibrillation after CABG are associated with increased hemodynamic disturbances, thromboembolic manifestations, readmission to the Intensive Care Unit (ICU), increased length of stay, organ failure, and death. This study aims to analyze the scoring system used for predicting the incidence of POAF in cardiac surgery. Methods:  This study used “POAF” AND “Scoring system," AND "CABG” AND “Atrial Fibrillation” as keywords to explore the literature from PubMed, Google Scholar, ProQuest, and Clinical Key. Search engines were searched for relevant papers from the last 15 years. Result: CHA2DS2-VASc score has a sensitivity of 74.2%, a specificity of 44.7% and can identify patients who are predicted to have a high risk of experiencing POAF by 49.4%. The CHA2DS2-VASc score can be used as an independent predictor for predicting POAF. HATCH score cut-off point exceeding 1 was linked to AF prediction, yielding a sensitivity of 42% and specificity of 70%. POAF Score, the scoring system anticipates an increased likelihood of POAF development (58.5%). A score of 1 corresponds to a 30.1% probability of POAF occurrence and is a practical point for commencing preventive therapy. Conclusion: Despite the various scoring systems used to predict postoperative atrial fibrillation, including the CHA2DS2-VASc score, HATCH score and Mariscalco. POAF Score demonstrated a validated ability to predict POAF.