Department of Cardiac Surgery ,Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Anesthesiology , Imam Reza Hospital , Mashhad University Of Medical Sciences ,Mashhad , Iran.
Background - Atrial fibrillation (AF) is the most common postoperative arrhythmic complication after coronary artery bypass graft surgery (CABG). The aim of the present study was to compare AF prevalence after off-pump versus on-pump CABG.
Methods- In this prospective study, performed between September 2008 and September 2009, 128 consecutive patients in our local cardiovascular surgery ward were allocated into two groups of off-pump (95 patients) and on-pump CABG (33 cases).We compared preoperative risk factors such as left ventricular ejection fraction (LVEF)<%40, hypertension (HTN), and Cr>2mg/dl, site of grafting such as the left coronary descending artery (LAD), right coronary artery (RCA), and left circumflex artery (LCX) in the two groups of surgery techniques (on-pump versus off-pump CABG) with/without postoperative AF after 24 hours of surgery in the Intensive Care Unit. Statistical power of the study was 80%, and a P-value less than 0.05 was considered significant.
Results - The prevalence of AF was 15 (15.8%) in the off-pump group versus 7 (21.2%) in the on-pump group (p=0.67) 24 hours after CABG. In the on-pump group, there was no difference between age categories (p=0.11). In the on-pump group, as opposed to the off-pump CABG group, there was no relationship between the surgery techniques with or without AF, LVEF<%40, and HTN. There was a significant relation with Cr more than 2 mg/dl in the on-pump CABG group (p=0.001) versus the off-pump CABG group (p=0.057).There was no statistical relation between the type of vascular graft (LAD, RCA, and LCX) between the on-pump and off-pump CABG patients attributed to with or without AF.
Conclusion - There was no reduction in the AF rate in the on-pump CABG versus off-pump CABG. It seems that there was another predictive factor for AF in the off and on-pump CABG groups, so further prospective trials with larger sample sizes are recommended.