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Factors Associated With Postoperative Arrhythmias in Patients Undergoing Isolated Off-Pump Coronary Artery Bypass
Gurpreet Panesar1, Nirja P Patel1, Kunal A Soni1
1Cardiac Anaesthesiology, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND.
Insights
Postoperative arrhythmia after coronary artery bypass grafting (CABG) is common. Diabetes and intraoperative heart rate changes increase arrhythmia risk in off-pump CABG patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Clinical Research
Background:
- Postoperative arrhythmia is a frequent complication following isolated coronary artery bypass grafting (CABG).
- This arrhythmia significantly contributes to patient morbidity and mortality.
- Identifying associated factors is crucial for risk stratification and prevention.
Purpose of the Study:
- To determine the incidence of postoperative arrhythmias in patients undergoing isolated off-pump CABG.
- To identify demographic and hemodynamic factors linked to these arrhythmias.
Main Methods:
- Prospective observational study of 100 patients undergoing isolated off-pump CABG.
- Intraoperative and postoperative data collection, including demographics and hemodynamics.
- Statistical analysis using bivariate and multivariate logistic regression.
Main Results:
- The overall incidence of postoperative arrhythmia was 23%, with atrial fibrillation in 17% and ventricular premature complexes in 6%.
- Multivariate analysis identified diabetes mellitus (OR 3.31), intraoperative bradycardia (OR 4.76), and intraoperative tachycardia (OR 8.89) as significant risk factors.
Conclusions:
- Diabetes mellitus and intraoperative hemodynamic instability are associated with increased risk of postoperative arrhythmias in off-pump CABG.
- Findings highlight the importance of managing these factors to potentially reduce arrhythmia incidence.
Abstract:
Background and aim Postoperative arrhythmia is very common after isolated coronary artery bypass grafting (CABG). Indeed, it is the most frequently encountered arrhythmia and an important contributor to postoperative morbidity and mortality. This study aimed to evaluate the incidence of postoperative arrhythmias and to identify factors associated with their occurrence in patients undergoing isolated off-pump CABG. Methods This prospective observational study was conducted on 100 patients who underwent isolated CABG at Bhanubhai and Madhuben Patel Cardiac Centre from January 2020 to September 2021. Demographic and hemodynamic data were recorded intraoperatively and postoperatively. The primary outcome was postoperative arrhythmia, and atrial fibrillation was analyzed as a subtype. Bivariate analysis followed by multivariate logistic regression was performed to identify factors associated with postoperative arrhythmia. Adjusted odds ratios (OR) with 95% confidence intervals (CI) were reported. Results The incidence of postoperative arrhythmia was 23%, of which atrial fibrillation occurred in 17% and ventricular premature complexes in 6% of patients. Univariate analysis revealed that age, diabetes mellitus, and intraoperative bradycardia were associated with the occurrence of arrhythmia. On multivariate logistic regression, diabetes mellitus (OR 3.31; 95% CI 0.97-11.27), intraoperative bradycardia (OR 4.76; 95% CI 1.06-21.27), and intraoperative tachycardia (OR 8.89; 95% CI 1.09-72.27) were associated with postoperative arrhythmia. Conclusions Diabetes mellitus and intraoperative hemodynamic variations were associated with postoperative arrhythmias in patients undergoing off-pump CABG. These findings represent associative relationships and should be interpreted cautiously given the observational design and limited sample size.
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