Off-pump CABG Does Not Reduce Incidence of Post-Operative Atrial Fibrillation

Off-pump coronary artery bypass grafting does not reduce the incidence of post-operative atrial fibrillation. This finding is in contrast to previous studies which reported a markedly lower incidence of post-operative atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting.

Researchers at the University of Virginia Medical Center, Charlottesville, Virginia and the Royal Melbourne Hospital, Parkville, Victoria, Australia, noted that the introduction of beating heart surgery had renewed interest in whether the technique reduced the incidence of post-operative atrial fibrillation.

The researchers reviewed the incidence of atrial fibrillation in 80 patients who had elective first-time off-pump grafting over a 16-month period. These patients were matched with 80 patients who underwent grafting with cardiopulmonary bypass. They collected data on pre-operative and operative variables and recorded the incidence of post-operative atrial fibrillation in both groups.

In the off-pump group, 27 patients (33.8 percent) had atrial fibrillation, which was similar to the 25 patients (31 percent) in the control group who had atrial fibrillation.

Increasing age was a significant risk factor for developing post-operative atrial fibrillation. Beta-blockade was found to be protective.

The researchers say that a randomised prospective trial has begun to look further into post-operative outcomes of off-pump coronary artery bypass grafting.

Heart, Lung and Circulation 2002;11:102-106