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Atrial fibrillation after off-pump coronary artery surgery: a prospective, matched study
1Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey. tturkon@yahoo.com
Insights
The type of coronary artery bypass graft (CABG) surgery, on-pump or off-pump, did not significantly impact the occurrence of new-onset atrial fibrillation (AF). Age was identified as the primary risk factor for post-CABG AF in this study.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Atrial fibrillation (AF) is a common complication following coronary artery bypass graft (CABG) surgery.
- The impact of cardiopulmonary bypass and myocardial ischemia on post-CABG AF remains a subject of investigation.
Purpose of the Study:
- To investigate the effect of on-pump versus off-pump CABG on the incidence of new-onset AF.
- To identify risk factors associated with post-operative AF after CABG.
Main Methods:
- A matched-pair analysis comparing 136 patients undergoing off-pump CABG with 136 patients undergoing on-pump CABG.
- Recording of potential risk factors for post-operative AF.
- Statistical analysis including univariate and multivariate models.
Main Results:
- Atrial fibrillation occurred in 24% of analyzed patients (64 out of 267).
- The incidence of AF was similar between the off-pump (22%) and on-pump (26%) groups, with no statistical significance.
- Age and length of hospital stay were significant risk factors on univariate analysis; only age remained significant in multivariate analysis.
Conclusions:
- The occurrence of atrial fibrillation after coronary artery bypass graft surgery is not dependent on the operative technique (on-pump vs. off-pump).
- Advanced age is the sole significant predictor of post-CABG AF, irrespective of surgical approach.
Abstract:
The effect of cardiopulmonary bypass and myocardial ischaemia on the occurrence of atrial fibrillation (AF) after coronary artery bypass graft (CABG) was studied in 136 patients undergoing off-pump CABG who were matched for age and number of distal anastomoses with 136 patients undergoing on-pump CABG. Possible risk factors for post-operative new-onset AF were recorded. AF occurred in 64 (24%) of the 267 patients for whom data could be analysed. AF occurred in 29 patients (22%) in the off-pump group versus 35 (26%) in the on-pump group, but this difference was not statistically significant. On univariate analysis, age and length of hospital stay were significant risk factors for the occurrence of AF. In a multivariate analysis that included operative technique, age was found to be the only significant risk factor. In conclusion, the occurrence of AF after CABG does not depend on the type of operation.
