Cardioplegic arrest does not increase the risk of atrial fibrillation after coronary artery bypass surgery

• Published in: European journal of cardio-thoracic surgery Vol. 25; no. 3; pp. 415 - 418
• Main Authors: Hakala, Tapio, Pitkanen, Otto, Hartikainen, Juha
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Science B.V 01.03.2004; Elsevier Science
• Subjects: Aged; Atrial fibrillation; Atrial Fibrillation - etiology; Biological and medical sciences; Cardiac dysrhythmias; Cardiology. Vascular system; Case-Control Studies; Coronary Artery Bypass - adverse effects; Coronary Artery Bypass - methods; Coronary Disease - surgery; Female; Heart; Heart Arrest, Induced - adverse effects; Heart Arrest, Induced - methods; Humans; Length of Stay; Male; Medical sciences; Off-pump coronary artery bypass grafting; On-pump coronary artery bypass grafting; Risk Factors; Treatment Outcome; Off-pump coronary artery bypass grafting; Atrial fibrillation; On-pump coronary artery bypass grafting; Arrhythmia; Coronary artery; Surgical anastomosis; Cardiovascular disease; Risk; Increase; Excitability disorder; Treatment; Aortocoronary; Bypass; Heart disease; Surgery; Risk factor
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/j.ejcts.2003.12.016

Objective: Atrial fibrillation (AF) is the most common arrhythmia after coronary artery bypass grafting (CABG). It is a considerable source of morbidity, prolongs hospital stay and increases costs of treatment. Atrial cannulation, cardiopulmonary bypass and cardioplegic arrest have been suggested to play a role in the development of AF after CABG. The aim of this case-control study was to evaluate the role of cardiopulmonary bypass and cardioplegic arrest in the development of postoperative AF. Methods: Data from 114 patients undergoing CABG without cardiopulmonary bypass and cardioplegic arrest (off-pump) between October, 1998 and December, 2002 were evaluated for the occurrence of postoperative AF. Each patient was individually matched by gender, age (±3 years), left ventricle ejection fraction (±5%), history of myocardial infarction, unstable angina, and β-blocker medication with patients undergoing CABG with cardiopulmonary bypass and cardioplegic arrest (on-pump) during the same period. The data from off-pump and on-pump groups were compared. Results: Off-pump and on-pump groups had similar preoperative characteristics. The number of distal anastomoses was lower in the off-pump (2.3±0.9) than in the on-pump (3.9±1.1, P<0.001) group. However, the incidence of postoperative AF in the off-pump (36.8%) and the on-pump groups (36.0%) did not differ from each other. Old age was the only independent predictor of AF after CABG. Conclusions: Neither cardiopulmonary bypass nor cardioplegic arrest increases the risk of postoperative AF after CABG.