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Aim: Postoperative Atrial Fibrillation (POAF) is a common complication following Coronary Artery Bypass Grafting (CABG), associated with increased morbidity and mortality. Aim of the study is to analyze whether the measurement of preoperative Left Atrial (LA) strain can offer advantages over conventional clinical and echocardiographic parameters to identify patients at risk of developing POAF., Methods and Results: We conducted a prospective study involving 100 patients undergoing isolated CABG from April 2023 to April 2024. Key parameters measured included LA strain measurements, Left Atrial Emptying Fraction (LA-EF), Left Ventricular Ejection Fraction, Left Atrial Volume index (LAVi). POAF occurred in 27 patients (27 %) with a mean latency of 3.2 ± 2.1 days. Higher preoperative serum creatinine levels were significantly associated with POAF. LA strain parameters (LA Reservoir Strain, LA Contraction Strain) and LA-EF were all significantly lower in the POAF group. Multivariate logistic regression identified LA Contraction Strain (OR: 0.73, p = 0.04), LA Reservoir Strain (OR: 0.27, p = 0.02) and preoperative serum creatinine (OR: 0.55, p = 0.01) as significant predictors of POAF. ROC curve analysis indicated that LA Reservoir Strain ≤24.5 %, LA Contraction Strain ≤9.5 %, LA-EF ≤ 43.4 % have a good accuracy in detection of POAF. Significant correlations were found between LAVi and LA Reservoir Strain, LAVi and LA-EF, and LA Reservoir Strain and LA-EF., Conclusions: Preoperative LA analysis are significant predictors of POAF. These findings suggest that echocardiographic strain measurements offer an added value in preoperative risk assessment for POAF in CABG patients., Competing Interests: Declaration of competing interest The authors did not receive support from any organization for the submitted work., (Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Atrial fibrillation (AF) is common in patients with cardiac amyloidosis (CA) and is a significant risk factor for heart failure hospitalization and thromboembolic events., Objective: This study was designed to investigate the atrial electrofunctional predictors of incident AF in CA., Methods: A multicenter, observational study was conducted in 4 CA referral centers including sinus rhythm patients with light-chain (AL) and transthyretin (ATTR) CA undergoing electrocardiography and cardiac magnetic resonance imaging. The primary end point was new-onset AF occurrence., Results: Overall, 96 patients (AL-CA, n = 40; ATTR-CA, n = 56) were enrolled. During an 18-month median follow-up (Q1-Q3, 7-29 months), 30 patients (29%) had incident AF. Compared with those without AF, patients with AF were older (79 vs 73 years; P = .001). They more frequently had ATTR (87% vs 45%; P < .001); electrocardiographic interatrial block (IAB), either partial (47% vs 21%; P = .011) or advanced (17% vs 3%; P = .017); and lower left atrial ejection fraction (LAEF; 29% vs 41%; P = .004). Age (hazard ratio [HR], 1.059; 95% CI, 1.002-1.118; P = .042), any type of IAB (HR, 2.211; 95% CI, 1.03-4.75; P = .041), and LAEF (HR, 0.967; 95% CI, 0.936-0.998; P = .044) emerged as independent predictors of incident AF. Patients exhibiting any type of IAB, LAEF <40%, and age >78 years showed a cumulative incidence for AF of 40% at 12 months. This risk was significantly higher than that carried by 1 (8.5%) or none (7.6%) of these 3 risk factors., Conclusion: In patients with CA, older age, IAB on 12-lead electrocardiography, and reduced LAEF on cardiac magnetic resonance imaging are significant and independent predictors of incident AF. A closer screening for AF is advisable in CA patients carrying these features., Competing Interests: Disclosures A.C. received honoraria from Alnylam, AstraZeneca, and Pfizer., (Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)