Evidence map›Paper›PMID 35993895›Full record

SynthesisInteractive cardiovascular and thoracic surgery2022

Preoperative P-wave parameters and risk of atrial fibrillation after cardiac surgery: a meta-analysis of 20 201 patients.

Michal J Kawczynski, Sophie Van De Walle, Bart Maesen, Aaron Isaacs, Stef Zeemering, Ben Hermans, Kevin Vernooy, Jos G Maessen, Ulrich Schotten, Elham Bidar

Open access · bronzeAbstract readMeta-Analysis
In one paragraph

Synthesis in Interactive cardiovascular and thoracic surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Prophylactic cardiac denervation to prevent post-operative atrial fibrillation after coronary artery bypass grafting: a systematic review and meta-analysis.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025
    Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Michal J KawczynskiDepartment of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands.
Sophie Van De WalleDepartment of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands.
Bart MaesenDepartment of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands.ORCID 0000-0001-8622-1450
Aaron IsaacsDepartment of Physiology, Maastricht University, Maastricht, Netherlands.ORCID 0000-0001-5037-4834
Stef ZeemeringDepartment of Physiology, Maastricht University, Maastricht, Netherlands.ORCID 0000-0003-3738-7328
Ben HermansDepartment of Physiology, Maastricht University, Maastricht, Netherlands.
Kevin VernooyCardiovascular Research Institute Maastricht (CARIM), Maastricht, Netherlands.ORCID 0000-0002-8818-5964
Jos G MaessenDepartment of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands.
Ulrich SchottenDepartment of Physiology, Maastricht University, Maastricht, Netherlands.ORCID 0000-0003-1532-3315
Elham BidarDepartment of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands.ORCID 0000-0002-9569-4900
Maastricht University Medical Centre · NLMaastricht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the role of P-wave parameters, as defined on preprocedural electrocardiography (ECG), in predicting atrial fibrillation after cardiac surgery [postoperative atrial fibrillation (POAF)].

methodsPubMed, Cochrane library and Embase were searched for studies reporting on P-wave parameters and risk of POAF. Meta-analysis of P-wave parameters reported by at least 5 different publications was performed. In case of receiver operator characteristics (ROC-curve) analysis in the original publications, an ROC meta-analysis was performed to summarize the sensitivity and specificity.

resultsThirty-two publications, with a total of 20 201 patients, contributed to the meta-analysis. Increased P-wave duration, measured on conventional 12-lead ECG (22 studies, Cohen's d = 0.4, 95% confidence interval: 0.3-0.5, P < 0.0001) and signal-averaged ECG (12 studies, Cohen's d = 0.8, 95% confidence interval: 0.5-1.2, P < 0.0001), was a predictor of POAF independently from left atrial size. ROC meta-analysis for signal-averaged ECG P-wave duration showed an overall sensitivity of 72% (95% confidence interval: 65-78%) and specificity of 68% (95% confidence interval: 58-77%). Summary ROC curve had a moderate discriminative power with an area under the curve of 0.76. There was substantial heterogeneity in the meta-analyses for P-wave dispersion and PR-interval.

conclusionsThis meta-analysis shows that increased P-wave duration, measured on conventional 12-lead ECG and signal-averaged ECG, predicted POAF in patients undergoing cardiac surgery.

Indexed as

Atrial FibrillationCardiac Surgical ProceduresElectrocardiographyHumansPostoperative ComplicationsRisk FactorsROC CurveSensitivity and SpecificityCardiac surgeryElectrocardiographyPostoperative atrial fibrillationReceiver operating curve meta-analysis

Identifiers

PMID35993895
PMCPMC9492265
OpenAlexW4292649225

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.