Postoperative atrial fibrillation: A comparison of off-pump coronary artery bypass surgery and conventional coronary artery bypass graft surgery

Postoperative atrial fibrillation: A comparison of off-pump coronary artery bypass surgery and conventional coronary artery bypass graft surgery

Objective: To compare the incidence and pattern of onset of postoperative atrial fibrillation (AF) in patients undergoing coronary artery bypass graft (CABG) surgery with and without cardiopulmonary bypass (CPB). Design: Retrospective, cohort-controlled study. Setting: University hospital and tertia...

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Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia Vol. 16; no. 2; pp. 144 - 148
Main Authors: Place, D.G., Peragallo, R.A., Carroll, J., Cusimano, R.J., Cheng, D.C.H.
Format: Journal Article
Language:English
Published: Philadelphia, PA Elsevier Inc 01-04-2002
Elsevier
Subjects:
Atrial Fibrillation - etiology
Biological and medical sciences
Cardiopulmonary Bypass - adverse effects
Coronary Artery Bypass - adverse effects
Coronary Artery Bypass - methods
Female
Humans
Length of Stay
Male
Medical sciences
Middle Aged
Postoperative Complications
Retrospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Water-Electrolyte Balance
Human
Postoperative
Arrhythmia
Atrial fibrillation
Coronary artery
Cardiovascular disease
Coronary heart disease
Excitability disorder
Pump
Cardiopulmonary bypass
Treatment
Bypass
Surgery
Adult
Complication
Graft
Technique
Comparative study
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Summary:Objective: To compare the incidence and pattern of onset of postoperative atrial fibrillation (AF) in patients undergoing coronary artery bypass graft (CABG) surgery with and without cardiopulmonary bypass (CPB). Design: Retrospective, cohort-controlled study. Setting: University hospital and tertiary referral center. Participants: A group of 108 consecutive patients who underwent primary off-pump coronary artery bypass (OP-CAB) surgery and a control group of 100 patients who underwent CABG surgery with CPB. All patients underwent surgery between January and September 1999. Interventions: Patients in the OP-CAB surgery group were operated on by either of 2 surgeons. The CABG surgery group was drawn from the general pool of patients operated on by 1 of 10 surgeons. All patients underwent median sternotomy and received standard anesthesia and intensive care unit management for this institution. Measurements and Main Results: Data from 99 OP-CAB surgery patients (data incomplete in 9 patients) were compared with data from 100 CABG surgery patients. General demographics were similar except the CABG surgery group received a higher mean number of distal anastomoses (3.3 v 3.0; p = 0.028) The incidence of AF was similar in both groups (OP-CAB surgery, 25% v CABG surgery, 18%; p = 0.228). The peak incidence of AF was postoperative day 2 in both groups. The median hospital length of stay was increased in patients developing AF. Conclusion: Avoiding CPB does not seem to reduce the incidence of postoperative AF in CABG surgery. The similar time distribution of onset of AF in OP-CAB surgery patients and CABG surgery patients may point toward a common cause.
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ISSN:1053-0770
1532-8422
DOI:10.1053/jcan.2002.31054