No Decrease in Incidence of Atrial Fibrillation in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting

Background: With the introduction of beating heart surgery, there has been a renewed interest in the incidence of postoperative atrial fibrillation (AF) in patients undergoing coronary artery bypass grafting (CABG). A small number of studies have reported markedly decreased incidences of postoperative AF in patients undergoing off-pump CABG.  The aim of the present study was to review the incidence of AF in patients undergoing off-pump CABG at Royal Melbourne Hospital.

Methods: A retrospective review was undertaken of 80 patients who had elective first-time CABG off-pump over a 16-month period. These patients were matched with 80 patients who underwent CABG with cardiopulmonary bypass (CPB). Data on preoperative and operative variables were collected. Incidences of postoperative AF in both groups were recorded.

Results: The incidence of AF in the off-pump group was 27 of 80 patients (34%) and in the CPB group it was 25 of 80 patients (31%; NS). Increasing age was a significant risk factor for developing postoperative AF, and beta-blockade was identified as a protective factor.

Conclusions: Off-pump CABG does not decrease the incidence of postoperative atrial fibrillation. A randomised prospective trial has been commenced at Royal Melbourne Hospital to further investigate postoperative outcomes of off-pump CABG.