Postoperative Atrial Fibrillation After Conventional and Beating Heart Myocardial Revascularization: Is there a culprit?

Abstract

This prospective randomized study was designed to determine the incidence and predictors of atrial fibrillation (AF) after conventional and off-pump coronary artery bypass (OPCAB) surgery and tis impact on length of postoperative hospital stay. This is a prospective randomized study of two hundred patients who underwent first time coronary artery bypass operation in cardiac surgery department of Mayo Hospital Lahore, there was equal number of patients in each group. (1) On – pump conventional surgery (100 patients, 82 men, mean age 62.5 years) using intermittent cross clamp fibrillation technique or (2) off-pump surgery (100 patients, 74 men, mean age 60.6 years) on the beating heart. Heart rate and rhythm were continuously monitored with an automated arrhythmia detector during the first 72 hours after surgery. Thereafter, routine clinical observation was performed and continuous monitoring restarted in the case of arrhythmia. There were no significant baseline differences among the two groups except that on-pump group received slightly higher mean number of distal anastomoses (3.3 v 3.0; p=0.028). 23 patients in the on-pump group and 16 in the off-pump group had sustained AF (p=0.228). the medina length of hospital stay was increased in-patients developing Atrial fibrillation. Atrial fibrillation is a common complication after procedures of myocardial revascularization, performed with or without cardiopulmonary bypass. Avoiding cardiopulmonary bypass does not seem to reduce the incidence of atrial fibrillation.