No decrease in incidence of atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting

Area of Science:

• Cardiology
• Cardiac Surgery
• Electrophysiology

Background:

• Beating heart surgery, specifically off-pump coronary artery bypass grafting (CABG), has prompted interest in its effect on postoperative atrial fibrillation (AF).
• Previous studies suggested lower AF rates with off-pump CABG, necessitating further investigation.

Purpose of the Study:

• To evaluate the incidence of postoperative atrial fibrillation (AF) in patients undergoing off-pump CABG.
• To compare AF rates between off-pump CABG and conventional CABG with cardiopulmonary bypass (CPB).

Main Methods:

• A retrospective review of 80 patients undergoing elective first-time off-pump CABG was conducted over 16 months.
• These patients were matched with 80 patients who underwent CABG with CPB.
• Preoperative, operative variables, and postoperative AF incidence were recorded for both groups.

Main Results:

• The incidence of postoperative AF was 34% (27/80) in the off-pump CABG group and 31% (25/80) in the CPB group (not significant).
• Advanced age was identified as a significant risk factor for developing postoperative AF.
• Beta-blockade therapy demonstrated a protective effect against postoperative AF.

Conclusions:

• Off-pump CABG does not appear to decrease the incidence of postoperative atrial fibrillation compared to CABG with CPB.
• A randomized prospective trial is underway to further explore postoperative outcomes of off-pump CABG.