Evaluation of Atrial Fibrillation Predictors in ECG After Mitral Valve Repair Surgery in Patients with Mitral Valve Prolapse

<i>Background and Objectives</i>: Atrial fibrillation (AF) is a common arrhythmia in patients with mitral valve prolapse (MVP) after mitral valve repair surgery and is associated with adverse cardiac outcomes. Early identification of patients at high risk for AF development after repair surgery is crucial for early treatment and follow-up of these patients. This study aimed to identify ECG predictors of AF in patients with MVP following mitral valve repair surgery. <i>Materials and Methods</i>: This retrospective, non-randomized study included 62 patients who underwent mitral valve repair for MVP. The patients' ECGs were analyzed preoperatively and at 1, 3, and 6 months post-surgery to identify patients who developed AF. AF was diagnosed based on ECG findings or Holter monitoring. The P wave dispersion, P wave peak time (PWPT), P wave duration, PR interval, P wave terminal force in lead V1 (PWTF), interatrial block, P wave axis, biphasic P waves in inferior leads, QRS duration, corrected QT interval (QTc), fragmented QRS (fQRS), and ST segment-T wave abnormalities were analyzed on baseline ECG as AF predictors. <i>Results</i>: The PWPT, P wave dispersion, and maximum P wave duration were significantly longer on preoperative ECG in patients who developed AF postoperatively compared to those who did not. Biphasic P waves were more frequently observed in patients who developed AF postoperatively. Univariate analysis identified biphasic P waves, P wave dispersion, maximum P wave duration, PWPT, and left ventricular ejection fraction (LVEF) as potential predictors of postoperative AF. However, multivariate analysis revealed that P wave dispersion, PWPT, and left atrial volume index (LAVI) were independent predictors of AF in six months after mitral valve repair. No significant changes were observed in QRS duration, QT interval, or the fQRS. <i>Conclusions</i>: The P wave dispersion, PWPT, and LAVI are significant ECG predictors of AF following mitral valve repair surgery in MVP patients. These ECG markers may help identify individuals at higher risk for postoperative AF, allowing for targeted monitoring and management strategies.