Incidence of postoperative atrial fibrillation in patients undergoing on-pump and off-pump coronary artery bypass grafting

Abstract

ObjectiveTo determine the incidence of postoperative atrial fibrillation in patients undergoing on-pump and off-pump coronary artery bypass grafting.MethodsA retrospective study with analysis of 230 medical records between January 2011 and October 2013 was conducted.ResultsFifty-six (24.3%) out of the 230 patients were female. The average age of patients undergoing on-pump coronary artery bypass grafting was 59.91±8.62 years old, and off-pump was 57.16±9.01 years old (P=0.0213). The average EuroSCORE for the on-pump group was 3.37%±3.08% and for the off-pump group was 3.13%±3% (P=0.5468). Eighteen (13.43%) patients who underwent off-pump coronary artery bypass grafting developed postoperative atrial fibrillation, whereas for the onpump group, 19 (19.79%) developed this arrhythmia, with no significant difference between the groups (P=0.1955).ConclusionOff-pump coronary artery bypass grafting did not reduce the incidence of atrial fibrillation in the postoperative period. Important predictors of risk for the development of this arrhythmia were identified as: patients older than 70 years old and presence of atrial fibrillation in perioperative period in both groups, and non-use of beta-blockers drugs postoperatively in the on-pump group.

Predictive factors of atrial fibrillation after coronary artery bypass grafting

“…(2-4,12) The mean age of patients who developed POAF was significantly higher than in patients who had arrhythmia. The anatomical and functional changes related to ageing and worsening of clinical conditions can contribute for this finding.…”

“…(8) In relation to use of ECC, researchers concluded that CABG without ECC did not reduce the incidence of POAF. (4) Measures that reflect intraoperative time of ischemic heart, such as aortic clamp time, have been reported as risk factors for POAF, although literature still controversial on the subject. (3,20) …”

“…(3) Although the type of surgery can influence the occurrence of POAF, we did not observe difference in incidence of arrhythmia in patients who underwent surgery with or without extracorporeal circulation (ECC). (3,4) …”

Predicting postoperative atrial fibrillation after myocardial revascularization without cardiopulmonary bypass: A retrospective cohort study

“…8,9,[11][12][13][14][15][16][17][18] Still, a few authors report PAOF frequencies lower than 15%. 4,10,15,19,20 According to most of the available literature, the use of cardiopulmonary bypass does not impact PAOF occurrence Abbreviations: AF, atrial fibrillation; DB, diagonal branch; DM, diabetes mellitus; COPD, chronic obstructive pulmonary disease; CI, confidence interval; CRF, chronic renal failure; LADA, left anterior descending artery; LMA, left marginal artery; OR, odds ratio; RCA, right coronary artery; SAH, systemic arterial hypertension. and the off-pump approach cannot be considered a protective factor for PAOF in patients undergoing CABG.…”

NEURL rs6584555 and CAND2 rs4642101 contribute to postoperative atrial fibrillation: a prospective study among Chinese population

“…General factors include older age, male gender, obesity, preexisting congestive heart failure, chronic renal failure, or COPD which are all risk factors for POAF [9–11]. Identification of patients who are at higher risk of POAF using genetic markers might be an important step for prevention of this type of operative complication and may provide important insight into the pathogenesis of atrial fibrillation (AF) and new therapeutic strategies for individual patients according to relative risk [12, 13]. …”