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Is atrial fibrillation caused by extracorporeal circulation?
K Saatvedt1, A E Fiane, O Sellevold
1Department of Cardiac Surgery, Feiring Heart Clinic, Norway. saatvedt@online.no
The Annals of Thoracic Surgery
|October 6, 1999
Summary
Postoperative atrial fibrillation is common after heart surgery. While not solely caused by extracorporeal circulation, transmyocardial laser revascularization significantly reduced its incidence compared to conventional or minimally invasive bypass surgery.
Area of Science:
- Cardiovascular Surgery
- Cardiac Electrophysiology
Background:
- Atrial fibrillation is a frequent complication after open-heart surgery, affecting up to 40% of patients.
- The exact causes of postoperative atrial fibrillation remain unclear, with extracorporeal circulation being a suspected factor.
Purpose of the Study:
- To investigate the relationship between different revascularization techniques and the incidence of postoperative atrial fibrillation.
- To compare atrial fibrillation rates in patients undergoing conventional bypass, minimally invasive bypass without cardiopulmonary bypass, and transmyocardial laser revascularization.
Main Methods:
- A retrospective study compared three groups of coronary artery disease patients (1997-1997).
- Group 1: Conventional coronary artery bypass grafting with cardiopulmonary bypass (n=685).
- Group 2: Minimally invasive coronary artery bypass grafting without cardiopulmonary bypass (n=19).
- Group 3: Off-pump transmyocardial laser revascularization (n=19).
Main Results:
- No significant difference in atrial fibrillation incidence was found between conventional bypass and minimally invasive bypass without cardiopulmonary bypass.
- The incidence of atrial fibrillation was significantly lower in the transmyocardial laser revascularization group compared to the other two groups.
Conclusions:
- Postoperative atrial fibrillation is not exclusively caused by extracorporeal circulation.
- Transmyocardial laser revascularization is associated with a significantly lower incidence of atrial fibrillation compared to conventional and minimally invasive bypass surgery.