[The results of pulmonary veins isolation to prevent postoperative atrial fibrillation].

AIM

To compare an efficacy of primary surgical (epicardial bipolar pulmonary veins isolation) and pharmacological (amiodarone) prevention of postoperative atrial fibrillation.

MATERIAL AND METHODS

The study included 117 patients with coronary artery disease without previous paroxysms of atrial fibrillation who were randomized into 3 groups. The first (I) group (n=39) included patients who underwent coronary artery bypass grafting without radiofrequency ablation of pulmonary veins and prophylactic amiodarone administration. The second (II) group (n=38) consisted of patients who received amiodarone as a prevention of postoperative atrial fibrillation. In the third (III) group (n=40) simultaneous CABG and pulmonary veins isolation were made.

RESULTS

The incidence of atrial fibrillation in early postoperative period was significantly lower in the 3rd group compared with control group (90% vs 69.2%, p=0.021). 1-year freedom from atrial fibrillation was 97.5% in group III vs. 84.2% in group II (p=0.004). In group I the incidence of early postoperative atrial fibrillation was 30.8% with following decrease to 17.9% in 12 months.

CONCLUSION

Simultaneous preventive pulmonary veins isolation during CABG is safe and effective, significantly reduces duration of hospital-stay and incidence of postoperative atrial fibrillation.