Atrial fibrillation after conventional and off-pump coronary artery bypass grafting: two opposite trends in timing of atrial fibrillation occurrence?

BACKGROUND

Atrial fibrillation (AF) is one of the most common complications after cardiac surgery. It occurs most often between the 2nd and 3rd postoperative day. The aim of this study was to compare the daily distribution of AF incidence between patients operated on with the standard coronary artery bypass grafting (CABG) technique and off-pump coronary artery bypass grafting on the beating heart (OPCABG) without extracorporeal circulation.

MATERIAL/METHODS: This was a prospective analysis of 1067 patients with coronary artery disease (CAD) operated on at our institute. 891 patients underwent CABG and 176 subjects were operated on by beating heart surgery using the OPCABG technique. Heart rhythm was analyzed continuously, and additionally a standard 12-lead ECG was performed once a day and continually in the case of clinical manifestations of arrhythmia. The observation period included 7 postoperative days (POD).

RESULTS

164 patients in the CABG group (18.43%) developed AF compared with 28 (16%) in the OPCABG group (OR=1.18; 95% CI (0.75-1.85); p=0.451). The peak of AF incidence in the CABG group appeared on the 2nd POD, while in contrast the peak of AF incidence after OPCABG was observed on the 1st POD.

CONCLUSIONS

We found no statistically significant difference in AF incidence after CABG and OPCABG. Different trends were noticed in the timing of occurrence of AF in these two groups.