Siebert Janusz, Lewicki Łukasz, Młodnicki Maciej, Rogowski Jan, Lango Romuald, Anisimowicz Lech, Narkiewicz Mirosława
Department of Cardiac Surgery and Cardiology, Institute of Cardiology, Medical University, Gdańsk, Poland.
Med Sci Monit. 2003 Mar;9(3):CR137-41.
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).
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.
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.
心房颤动（AF）是心脏手术后最常见的并发症之一。它最常发生在术后第2天至第3天之间。本研究的目的是比较采用标准冠状动脉旁路移植术（CABG）技术进行手术的患者与在非体外循环下进行心脏不停跳冠状动脉旁路移植术（OPCABG）的患者之间房颤发生率的每日分布情况。
材料/方法：这是对在我们研究所接受手术的1067例冠心病（CAD）患者进行的前瞻性分析。891例患者接受了CABG手术，176例患者采用OPCABG技术进行了心脏不停跳手术。持续分析心律，此外，每天进行一次标准12导联心电图检查，若出现心律失常临床表现则持续进行检查。观察期包括术后7天（POD）。
CABG组有164例患者（18.43%）发生房颤，而OPCABG组有28例患者（16%）发生房颤（OR = 1.18；95%CI（0.75 - 1.85）；p = 0.451）。CABG组房颤发生率的峰值出现在术后第2天，而相比之下，OPCABG术后房颤发生率的峰值出现在术后第1天。
我们发现CABG和OPCABG术后房颤发生率在统计学上无显著差异。在这两组中，房颤发生的时间出现了不同的趋势。
