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Off-pump coronary artery bypass grafting does not decrease the incidence of atrial fibrillation.

Thomas Salamon1, Robert E Michler, Kelly M Knott

  • 1Division of Cardiothoracic Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA.

The Annals of Thoracic Surgery
|February 28, 2003
PubMed
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Avoiding cardiopulmonary bypass during coronary artery bypass grafting did not reduce the incidence of postoperative atrial fibrillation. This study found no significant benefit in preventing this common complication by omitting cardiopulmonary bypass.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Anesthesia
  • Cardiac Surgery Outcomes

Background:

  • Postoperative atrial fibrillation is a common complication after coronary artery bypass grafting (CABG).
  • The use of cardiopulmonary bypass (CPB) is a known risk factor for developing atrial fibrillation.
  • This study investigated whether avoiding CPB could lower the incidence of postoperative atrial fibrillation.

Purpose of the Study:

  • To determine if eliminating cardiopulmonary bypass during CABG surgery reduces the occurrence of postoperative atrial fibrillation.
  • To compare the incidence of atrial fibrillation in patients undergoing off-pump CABG versus on-pump CABG.

Main Methods:

  • A retrospective review of 2,569 patients undergoing CABG was conducted.
  • Patients were divided into four groups: off-pump CABG (n=252), on-pump CABG (n=1,470), on-pump CABG with similar grafts (n=841), and historical on-pump CABG (n=847).

Related Experiment Videos

  • Prophylactic beta-blockade was administered to groups 1-3 but not group 4.

    • Main Results:

    • The incidence of atrial fibrillation was 8.8% in the off-pump group (group 1).
    • Incidences in the on-pump groups were 11.6% (group 2), 9.4% (group 3), and 28.0% (group 4).
    • The difference in atrial fibrillation incidence between group 1 and group 4 was statistically significant (p <.0001).

    Conclusions:

    • Avoiding cardiopulmonary bypass did not significantly reduce the incidence of postoperative atrial fibrillation at this institution.
    • The findings suggest that off-pump CABG may not be superior to on-pump CABG for preventing atrial fibrillation.
    • Further research may be needed to identify optimal strategies for reducing postoperative atrial fibrillation after CABG.