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Published on: February 26, 2013
No decrease in incidence of atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting
Silvana F Marasco1, John Goldblatt, Michael McDonald
1Cardiothoracic Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia. silvanamarasco@hotmail.com
Insights
Off-pump coronary artery bypass grafting (CABG) did not reduce the incidence of postoperative atrial fibrillation (AF) compared to traditional CABG with cardiopulmonary bypass. Age was a risk factor, while beta-blockade was protective.
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.
Background:
With the introduction of beating heart surgery, there has been a renewed interest in the incidence of postoperative atrial fibrillation (AF) in patients undergoing coronary artery bypass grafting (CABG). A small number of studies have reported markedly decreased incidences of postoperative AF in patients undergoing off-pump CABG.
Aims:
The aim of the present study was to review the incidence of AF in patients undergoing off-pump CABG at Royal Melbourne Hospital.
Methods:
A retrospective review was undertaken of 80 patients who had elective first-time CABG off-pump over a 16-month period. These patients were matched with 80 patients who underwent CABG with cardiopulmonary bypass (CPB). Data on preoperative and operative variables were collected. Incidences of postoperative AF in both groups were recorded.
Results:
The incidence of AF in the off-pump group was 27 of 80 patients (34%) and in the CPB group it was 25 of 80 patients (31%; NS). Increasing age was a significant risk factor for developing postoperative AF, and beta-blockade was identified as a protective factor.
Conclusions:
Off-pump CABG does not decrease the incidence of postoperative atrial fibrillation. A randomised prospective trial has been commenced at Royal Melbourne Hospital to further investigate postoperative outcomes of off-pump CABG.
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