Right atrial overdrive pacing does not prevent atrial fibrillation after coronary artery bypass surgery.
OBJECTIVE
The purpose of this prospective randomized study was to investigate the efficacy of atrial overdrive pacing (AOP) and bradycardia prevention pacing (BPP) in the prophylaxis of atrial fibrillation (AF) after coronary artery bypass surgery (CABG).


METHODS
One hundred and twenty-four on-pump CABG patients were randomized into three groups: AOP, BPP, and NP (no pacing). AOP patients were paced via epicardial wires using an atrial preference pacing algorithm, and BPP patients were paced in the AAI mode with a base rate of 60/min. Patients were paced for 48 h starting on the first postoperative day. The endpoint of the study was the first onset of AF lasting longer than 5 min.


RESULTS
Preoperative risk factors and surgical data of patients did not differ between the AOP, BPP and NP groups. Pacing was technically successful in 80.5% of patients in the AOP and in 92.7% in the BPP groups. The incidence of AF in the AOP (26.8%), BPP (19.5%) and NP (28.6%) groups did not differ significantly. In the AOP group, AF in three patients was probably induced by inappropriate pacing due to sensing failure.


CONCLUSIONS
Atrial overdrive pacing and bradycardia prevention pacing were not effective in the prevention of AF after CABG.
Hakala
Tapio
T
Department of Surgery, Kuopio University Hospital, P.O. Box 1777, FIN-70211 Kuopio, Finland. tapio.hakala@kuh.fi
Valtola
Antti J M
AJ
Turpeinen
Anu K
AK
Hedman
Antti E
AE
Vuorenniemi
Rauli E U
RE
Karjalainen
Jari M
JM
Vajanto
Ismo S
IS
Kouri
Juhani
J
Jaakkola
Pekka A
PA
Hartikainen
Juha E K
JE
D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control*; D001919:Bradycardia / Q000209:etiology / Q000517:prevention & control; D002304:Cardiac Pacing, Artificial; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome