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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Postoperative Atrial Fibrillation Impacted by Completeness of Coronary Revascularization and Antiplatelet Regimen

Qin Jiang1,2,3, Minghui Xie4, Yalu Yu3

  • 1Department of Cardiac Surgery, Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology, Chengdu, Sichuan, China, samsph.com.

Cardiovascular Therapeutics
|March 2, 2026
PubMed

Insights

Incomplete revascularization after off-pump coronary artery bypass grafting increases postoperative atrial fibrillation (POAF) risk, especially with clopidogrel. Complete revascularization is associated with lower POAF rates, regardless of antiplatelet choice.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Arrhythmia Research

Background:

  • Postoperative atrial fibrillation (POAF) is a frequent complication following off-pump coronary artery bypass grafting (OPCABG).
  • Both myocardial ischemia and systemic inflammation are key factors in POAF development.
  • POAF is linked to poorer patient outcomes and extended hospital stays.

Purpose of the Study:

  • To examine the combined effect of revascularization completeness and antiplatelet therapy on POAF incidence.
  • To investigate the relationship between coronary revascularization extent and POAF in OPCABG patients.

Main Methods:

  • Retrospective analysis of 505 patients undergoing elective first-time OPCABG.
  • Patients categorized into incomplete revascularization (IR) and complete revascularization (CR) groups.
  • Comparison of POAF incidence, AF burden, inflammatory markers, and hospital stay between groups.

Main Results:

  • POAF incidence was significantly higher in the IR group (39.2%) compared to the CR group (25.1%).
  • The IR group exhibited increased AF burden, higher IL-6 and D-dimer levels, and longer hospital stays.
  • Among patients on clopidogrel, IR was linked to higher POAF rates (42.6% vs. 25.9%), but this association was not observed with ticagrelor.

Conclusions:

  • Incomplete revascularization is a significant risk factor for POAF post-OPCABG, particularly in patients treated with clopidogrel.
  • Complete revascularization may mitigate POAF risk, irrespective of the dual antiplatelet therapy regimen used.
  • The choice of antiplatelet therapy interacts with revascularization completeness in influencing POAF development.
Abstract

Keywords:
completeness of coronary revascularizationcoronary artery bypass surgerydual antiplatelet therapypostoperative atrial fibrillation

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