The Incidence of Atrial Fibrillation after On-Pump Versus Off-Pump Coronary Artery Bypass Grafting
Effects of pump and off-pump CABG on postoperative atrial fibrillation
DOI:
https://doi.org/10.1532/hsf.3873Keywords:
Postoperative atrial fibrillation, effects of cardiopulmonary bypass, coronary artery bypass surgery, rhythm disordersAbstract
Background: This study aimed to investigate the incidence of postoperative atrial fibrillation (POAF) in patients undergoing off-pump versus on-pump coronary artery bypass grafting (CABG) under cardiopulmonary bypass (CPB).
Methods: A total of 3,197 consecutive patients (1,816 males, 1,381 females; mean age: 60.8 ± 9.8 years) with preoperative sinus rhythm who underwent CABG at a cardiovascular surgery clinic between November 2009 and March 2014 retrospectively were analyzed. Of the patients, 1,680 underwent on-pump and 1,517 underwent off-pump cardiac surgery. Data, including demographic characteristics, preoperative risk factors, preoperative medications, laboratory test results, postoperative data and complications, and mortality and morbidity rates, were recorded.
Results: According to the multivariate analysis, the type of operation, number of anastomoses, right coronary artery or right coronary posterior descending artery graft, vasopressor therapy (epinephrine, norepinephrine), operation duration, age >60 years, hypertension, length of hospital stay >4 days, and obstructive sleep apnea syndrome (OSAS) were the independent predictors of POAF after CABG. Our study results suggest that on-pump CABG under CPB is correlated with POAF.
Conclusion: We recommend using off-pump CABG in select cases to minimize the risk of POAF.
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