Atrial fibrillation after surgical revascularization: is there any difference between on-pump and off-pump?

Abstract

There is no reduction of AF rate in myocardial revascularization without cardiopulmonary bypass. However, prophylactic beta-blocker usage decreases the incidence of AF after both on-pump and off-pump myocardial revascularization.

Preoperative plasma brain natriuretic peptide level is an independent predictor of postoperative atrial fibrillation following off-pump coronary artery bypass surgery

“…Biomarkers indicating infl ammatory status, such as baseline C-reactive protein level, postoperative elevation of interleukin-6, and white blood cell count have been reported as independent predictors of AF following both conventional CABG and OPCAB [13][14][15]. However, only advancing age has consistently been shown to be associated with the development of postoperative AF following both conventional CABG and OPCAB [3,5,8,9]. Consequently, we examined independent predictors of postoperative AF following OPCAB from the viewpoint of left ventricular (LV) function.…”

“…Although a recent metaanalysis showed OPCAB signifi cantly reduced the incidence of postoperative AF compared with conventional CABG [6], the incidence of postoperative AF following OPCAB has been reported to remain high, at 21%-32% [2,3,[7][8][9]. Several factors, including low ejection fraction, and cardiac arrest have been reported as predictors of postoperative AF following conventional CABG [5,[10][11][12]. On the other hand, some perioperative factors have also been reported to be predictors of postoperative AF following OPCAB [7,8,13].…”

“…Offpump coronary artery bypass (OPCAB) surgery has been widely used over the past decade. However, controversy still remains as to whether OPCAB can reduce the incidence of postoperative AF [2][3][4][5]. Although a recent metaanalysis showed OPCAB signifi cantly reduced the incidence of postoperative AF compared with conventional CABG [6], the incidence of postoperative AF following OPCAB has been reported to remain high, at 21%-32% [2,3,[7][8][9].…”

Risk Factors of Atrial Fibrillation Following Coronary Artery Bypass Grafting

“…He also observed that prophylactic -blocker usage decreased the incidence of AF after both on-pump and off-pump myocardial revascularization. 13 According to the results of many opposing studies related to postoperative AF following CABG or OPCAB surgery, a large, multicenter study should be performed in order to clear this problem up finally. 12,13 Our preliminary results partially confirmed the results obtained by other authors; however, some risk factors are completely new and oppose the outcomes above.…”

The statin therapy to prevent atrial fibrillation after cardiac surgery: Shakespearean dilemma

“…As such, off-pump CABG (OPCAB) is believed to elicit less systemic inflammation than on-pump surgery because of reduced cytokine responses and less myocardial injury (22). However, the association between OPCAB and a lower incidence of atrial arrhythmias were not confirmed by several studies suggesting that surgical stress is more important triggering of POAF than systemic inflammation (22). These results need to interpretation because some of these have a retrospective design with small sample size, and that they all showed at least a nonsignificant trend towards lower AF incidence in off-pump surgery.…”