Atrial fibrillation following off-pump versus on-pump coronary artery bypass grafting: Incidence and risk factors

Abstract

Background: Postoperative atrial fibrillation (AF) is a common arrhythmia that occurs after coronary artery bypass grafting (CABG). 3% and 19.3% of CABG and OPCAB patients, respectively (p = 0.3). The peak incidence of arrhythmia was observed between the second and third postoperative day in both CABG and OPCAB patients (36% and 41%, respectively). Patient's age and history of hypertension were significant predictors of postoperative AF (OR 1.38, p = 0.0002; and OR 1.38, p = 0.008, respectively). Patients who developed AF vs. without AF had significantly higher rates of complications such as death (3.1% vs. 1.2%, p = 0.01), reoperation (5.2% vs. 2.8%, p = 0.02), and the need to utilize intra-aortic balloon pump (IABP) (6.8% vs. 3.4%, p = 0.002). Use of IABP and reoperation were significant perioperative predictors of the arrhythmia (OR 2.1, p = 0.003; and OR 1.9, p = 0.02, respectively). AF was also associated with a prolonged stay in an intensive care unit (72.5 ± 78.8 for patients with AF vs. 34.6 ± 25.2 for patients with sinus rhythm, p = 0.000001). Conclusions:In patients undergoing CABG, postoperative AF is a common arrhythmia independent of the type of surgical procedure. (Cardiol J 2016; 23, 5: 518-523)

Newly developed post-operative atrial fibrillation is associated with an increased risk of late recurrence of atrial fibrillation in patients who underwent open heart surgery: Long-term follow up

“…This can be explained that type and complexity of surgery may influence the degree of inflammation and alteration of hemodynamic status which can induce AF during post-operative period, however, type of surgery rarely affects development of AF after recovery of post-operative condition and correction of pre-operative disease. Similarly, OPCAB did not affect the incidence of POAF as previously reported [13] and we found that the development of late AF was not related with OPCAB. Second, among the research to date, the present study evaluated the occurrence of late AF for the longest follow up period (mean follow up period of 78.1 ± 39.1 months).…”

Early-Term Outcomes of Off-Pump versus On-Pump Beating-Heart Coronary Artery Bypass Surgery

“…27 On the contrary, some other reports demonstrated that when OPCAB was compared with on-pump procedure, the former did not decrease AF occurrence during postoperative period, and AF occurrence rates were similar between both the procedures. [28][29][30] Except for AF, other postoperative complications and mortality rates were similar between the groups in our study.…”

New-Onset Atrial Fibrillation after Off-Pump Coronary Artery Bypass Grafting: Predictors and In-hospital Complications

“…within the incidence of prior studies [1][2] [3] . Age is one of the most consistent risk factors for postoperative AF in many previous literature [4] [15] , which was also supported by our research. The effect of advanced age on AF may relate to degenerative changes in atrial structure and function [11] .…”

“…IABP is not a variable often included in previous research. Consistent with our ndings, Lewicki et al conducted a study included 1836 patients who underwent CABG and identi ed that IABP was an independent predictor of new-onset AF after CABG [15] . Inversely, Thoren et al disagreed with this conclusion [21] .It might be due to the fact that the majority of the operations (96%) were performed onpump in their study cohort, which is dramatically different from ours.…”