Postoperative atrial fibrillation: a comparison of off-pump coronary artery bypass surgery and conventional coronary artery bypass graft surgery.
OBJECTIVE
To compare the incidence and pattern of onset of postoperative atrial fibrillation (AF) in patients undergoing coronary artery bypass graft (CABG) surgery with and without cardiopulmonary bypass (CPB).


METHODS
Retrospective, cohort-controlled study.


METHODS
University hospital and tertiary referral center.


METHODS
A group of 108 consecutive patients who underwent primary off-pump coronary artery bypass (OP-CAB) surgery and a control group of 100 patients who underwent CABG surgery with CPB. All patients underwent surgery between January and September 1999.


METHODS
Patients in the OP-CAB surgery group were operated on by either of 2 surgeons. The CABG surgery group was drawn from the general pool of patients operated on by 1 of 10 surgeons. All patients underwent median sternotomy and received standard anesthesia and intensive care unit management for this institution.


RESULTS
Data from 99 OP-CAB surgery patients (data incomplete in 9 patients) were compared with data from 100 CABG surgery patients. General demographics were similar except the CABG surgery group received a higher mean number of distal anastomoses (3.3 v 3.0; p = 0.028) The incidence of AF was similar in both groups (OP-CAB surgery, 25% v CABG surgery, 18%; p = 0.228). The peak incidence of AF was postoperative day 2 in both groups. The median hospital length of stay was increased in patients developing AF.


CONCLUSIONS
Avoiding CPB does not seem to reduce the incidence of postoperative AF in CABG surgery. The similar time distribution of onset of AF in OP-CAB surgery patients and CABG surgery patients may point toward a common cause.
Place
D G
DG
Department of Anesthesia, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Peragallo
R A
RA
Carroll
J
J
Cusimano
R J
RJ
Cheng
D C H
DC
D001281:Atrial Fibrillation / Q000209:etiology*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D014882:Water-Electrolyte Balance