Influence of external temporary biatrial pacing on the prevention of atrial fibrillation after coronary artery bypass without extracorporeal circulation.
BACKGROUND
Atrial fibrillation is the most common complication after myocardial revascularization, and it increases morbidity/mortality.


OBJECTIVE
The purpose of this prospective randomized study was to test the hypothesis that temporary biatrial pacing is effective in reducing the incidence of postoperative atrial fibrillation after myocardial revascularization.


METHODS
Ninety-eight non-consecutive patients who had undergone off-pump myocardial revascularization received two temporary electrodes attached to the right and left atria, which were connected to either pair of atrial pacemaker electrodes, in addition to the leads implanted in the right ventricle. Two groups of patients were randomized (control: 49 patients with no biatrial pacing; therapeutic: 49 patients with biatrial pacing). The variables of interest were atrial fibrillation (present or absent) and length of hospital stay.


RESULTS
The incidence of atrial fibrillation was 36.73% in the control group and 14.29% in the therapeutic group (p=0.0194). Length of hospital stay was 7.00 +/- 2.82 days for patients with no atrial fibrillation (n=73) and 9.20 +/- 2.87 days for patients with atrial fibrillation (n=25) (p=0.0001). Age was an important predictor of arrhythmia and ranged between 62.34 +/- 9.00 years in the group with no atrial fibrillation and 67.20 +/- 7.42 years in the group with atrial fibrillation (p=0.0170).


CONCLUSIONS
Compared to controls, prophylactic temporary biatrial pacing is effective in preventing atrial fibrillation. Hospital stay was longer for patients who developed postoperative atrial fibrillation, and age was an important predictor for the development of arrhythmia.
Silva
Francisco Maia da
FM
Pontifícia Universidade Católica do Paraná, Curitiba, PR - Brasil. francmaia@cardiol.br
Milani
Rodrigo
R
Précoma
Dalton
D
Guimarães
Maximiliano
M
Moutinho
Jose Augusto
JA
Barboza
Laura
L
Sartori
Alexandre
A
Brofman
Paulo
P
D000328:Adult; D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000517:prevention & control*; D001938:Brazil / Q000453:epidemiology; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D004812:Epidemiologic Methods; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period