Effects of biatrial pacing in prevention of postoperative atrial fibrillation after coronary artery bypass surgery

Area of Science:

• Cardiology
• Cardiac Surgery
• Electrophysiology

Background:

• Atrial fibrillation (AF) is a frequent complication following coronary artery bypass surgery (CABG).
• Post-CABG AF leads to extended hospital stays and increased healthcare costs.
• Preventing AF after CABG is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of biatrial pacing in preventing AF after CABG.
• To compare biatrial pacing with single-site atrial pacing (left or right atrial pacing) and no pacing.

Main Methods:

• 132 patients undergoing CABG without prior AF history were randomized into four groups: biatrial pacing (BiA), left atrial pacing (LA), right atrial pacing (RA), or control (no pacing).
• Overdrive atrial pacing was administered for five postoperative days.
• Incidence of AF, P-wave duration (P(dur)), and P-wave dispersion (P(dis)) were measured.

Main Results:

• Biatrial pacing significantly reduced AF incidence (12.5%) compared to LA (36.4%), RA (33.3%), and control (41.9%) groups (P<0.05).
• The BiA group experienced a significantly shorter hospital stay.
• Biatrial pacing led to the greatest reduction in P-wave dispersion (42%) compared to LA (13%) and RA (10%) groups (P<0.05).

Conclusions:

• Biatrial overdrive pacing is superior to single-site atrial pacing in preventing post-CABG AF.
• This pacing strategy shortens hospital stays.
• The reduction in atrial activation time and P-wave dispersion supports the effectiveness of biatrial pacing.