Post-operative atrial fibrillation in off pump coronary artery bypass graft: association with medication

Abstract

Background: Post-operative atrial fibrillation is a common post-operative complication and has significant morbidity and mortality. This study was done with an objective to determine the association of various medication use in patients undergoing coronary artery bypass graft (CABG) with post-operative atrial fibrillation (POAF).Methods: This was a prospective observational study done in the department of cardiovascular and thoracic surgery of GMC Kottayam from December 2019 to December 2020 after obtaining institutional review board clearance. A sample size of 334 was fixed and patients undergoing off pump (OP) CABG were consecutively recruited in the study. The association of intraoperative and postoperative medication use with occurrence of POAF were analysed using the univariate analysis with a p<0.05 using the SPSS 16 software.Results: Peri-operative inotrope use was found to be significantly associated with post operative atrial fibrillation odds ratio 1.08 (95% CI 1.02-1.13). We could not find any association with preoperative use of beta blockers/agonist, antidiabetics, levothyroxine, ACE inhibitors or antiplatelet drugs. All the patients 60 (18%) who developed POAF were given amiodarone as per protocol.Conclusions: Perioperative inotrope use was found to have significant association with the development of post operative atrial fibrillation following OPCABG. More multi-institutional studies with determination of association with individual drugs and doses with POAF need to be conducted in future.

Postoperative Atrial Fibrillation Prevention in Patients Undergoing Coronary Artery Bypass Grafting by Using Perioperative HCN Channel Blockers and Selective Beta Blockers

“…Investigations into beta-adrenergic antagonists for the management of postoperative atrial fibrillation have yielded positive outcomes [4][5][6][7] .…”