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Does Off-pump Coronary Artery Bypass Reduce the Prevalence ofAtrial Fibrillation?
Khosrow Hashemzadeh1, Marjan Dehdilani, Mahnaz Dehdilani
1Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Insights
Off-pump Coronary Artery Bypass Grafting (CABG) significantly reduces the incidence of postoperative atrial fibrillation (POAF) compared to on-pump CABG. Patients undergoing off-pump CABG also showed a higher probability of converting to sinus rhythm post-treatment.
Area of Science:
- Cardiovascular Surgery
- Cardiac Arrhythmias
- Surgical Outcomes
Background:
- Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery.
- Coronary Artery Bypass Grafting (CABG) is a standard procedure for coronary artery disease.
- The impact of off-pump versus on-pump CABG on POAF incidence requires further investigation.
Purpose of the Study:
- To compare the incidence of POAF between off-pump CABG and on-pump CABG.
- To identify predictive risk factors for POAF in both surgical groups.
- To evaluate the conversion rate to sinus rhythm after POAF treatment in relation to surgical technique.
Main Methods:
- A comparative study involving 939 coronary artery disease patients in sinus rhythm.
- Patients were divided into off-pump CABG (383 patients) and on-pump CABG (556 patients) groups.
- Postoperative monitoring in the ICU was conducted to determine POAF incidence and risk factors.
Main Results:
- The incidence of POAF was significantly lower in the off-pump CABG group (9.9%) compared to the on-pump CABG group (16.7%) (P=0.002).
- Age over 65 years was identified as a significant preoperative risk factor for POAF in both groups.
- Conversion to sinus rhythm was significantly more probable in the off-pump group (P=0.006).
Conclusions:
- Off-pump CABG is associated with a reduced prevalence of POAF compared to on-pump CABG.
- Off-pump techniques may facilitate a more probable conversion to sinus rhythm following POAF treatment.
- Age remains a critical factor influencing POAF risk irrespective of CABG technique.
Introduction:
To examine whether or not off-pump CABG (Coronary Artery Bypass Reduce) reduces the incidence of AF after cardiac surgery.
Methods:
The study was carried out in 939 consecutive coronary artery disease patients with sinus rhythm from which 383 patients underwent off-pump CABG, and 556 patients were operated through on-pump CABG. All patients were monitored postoperatively during intensive care unit (ICU) stay. Then, the incidence and predictive risk factors of post operative AF (POAF) in two groups were determined and compared with each other.
Results:
Overall, the mean age of the patients was 56.0±12.8 years with 234 patients (24.9%) being older than 65 years. POAF developed in 38 patients (9.9%) of the off-pump and in 93 patients (16.7%) of the on-pump CABG. There was significant difference between two groups when considering the incidence of POAF (P=0.002). Among preoperative risk factors, age>65 years had a significant association with the incidence of AF in both groups. This study also showed that most of the POAF cases converted to sinus rhythm after treatment. Moreover, these finding demonstrated that conversion to sinus rhythm is significantly more probable in off-pump group (P=0.006).
Conclusion:
A reduced prevalence of POAF could be observed in patients with off-pump as compared with on-pump techniques. Furthermore, conversion to sinus rhythm in off-pump group was significantly more probable than on-pump group.
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