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Abstract

Background: Post-operative atrial fibrillation (POAF) is a common complication following cardiac surgery, leading to increased morbidity and longer hospital stays. Diabetes mellitus may increase the risk of POAF, but its exact role in this population is still not fully understood.
Objective: To evaluate the effect of diabetes mellitus on the occurrence of post-operative atrial fibrillation in patients undergoing cardiac surgery and to examine the association of clinical factors, including myocardial infarction, infarction location, and type of surgical procedure, with the development of POAF.
Materials and Methods: This comparative cross-sectional study was conducted at a tertiary care hospital in Peshawar from July to December 2024, involving 140 adult cardiac surgery patients divided into diabetic and non-diabetic groups. Demographic and clinical variables were recorded, and POAF was monitored via ECG. Associations between diabetes, myocardial infarction, MI location, and surgical procedure with POAF were analyzed using Chi-square and t-tests, with p < 0.05 considered statistically significant.
Results: A total of 140 patients undergoing cardiac surgery were included, with a mean age of 55.6 ± 12.8 years. The majority were male (n = 99, 70.7%), and 62 (44.3%) had diabetes mellitus. Pre-operative atrial fibrillation (AF) was observed in 67 (47.9%) patients, increasing to 87 (62.1%) post-operatively. POAF occurred in 74.2% of diabetic versus 52.6% of non-diabetic patients (p = 0.009). While CABG was the most frequent procedure among patients who developed POAF (n = 72, 82.8%), the type of surgery was not significantly associated with POAF (p = 0.060).
Conclusion: Diabetes mellitus and myocardial infarction significantly increase the risk of developing POAF following cardiac surgery. Early identification and optimal management of these high-risk patients may improve surgical outcomes and reduce arrhythmic complications.