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Eur J Cardiothorac Surg 2004;25:415-418
© 2004 Elsevier Science NL

Cardioplegic arrest does not increase the risk of atrial fibrillation after coronary artery bypass surgery

^a Department of Surgery, Kuopio University Hospital and Kuopio University, P.O. Box 1777, FIN-70211 Kuopio, Finland
^b Department of Anesthesiology and Intensive Care, Kuopio University Hospital and Kuopio University, Kuopio, Finland
^c Department of Medicine, Kuopio University Hospital and Kuopio University, Kuopio, Finland

Received 27 September 2003; received in revised form 10 December 2003; accepted 15 December 2003.

^* Corresponding author. Tel.: +358-17-173-311; fax: +358-17-173-746
e-mail: tapio.hakala{at}kuh.fi

Objective: Atrial fibrillation (AF) is the most common arrhythmia after coronary artery bypass grafting (CABG). It is a considerable source of morbidity, prolongs hospital stay and increases costs of treatment. Atrial cannulation, cardiopulmonary bypass and cardioplegic arrest have been suggested to play a role in the development of AF after CABG. The aim of this case-control study was to evaluate the role of cardiopulmonary bypass and cardioplegic arrest in the development of postoperative AF. Methods: Data from 114 patients undergoing CABG without cardiopulmonary bypass and cardioplegic arrest (off-pump) between October, 1998 and December, 2002 were evaluated for the occurrence of postoperative AF. Each patient was individually matched by gender, age (±3 years), left ventricle ejection fraction (±5%), history of myocardial infarction, unstable angina, and ß-blocker medication with patients undergoing CABG with cardiopulmonary bypass and cardioplegic arrest (on-pump) during the same period. The data from off-pump and on-pump groups were compared. Results: Off-pump and on-pump groups had similar preoperative characteristics. The number of distal anastomoses was lower in the off-pump (2.3±0.9) than in the on-pump (3.9±1.1, P<0.001) group. However, the incidence of postoperative AF in the off-pump (36.8%) and the on-pump groups (36.0%) did not differ from each other. Old age was the only independent predictor of AF after CABG. Conclusions: Neither cardiopulmonary bypass nor cardioplegic arrest increases the risk of postoperative AF after CABG.

Key Words: Atrial fibrillation • Off-pump coronary artery bypass grafting • On-pump coronary artery bypass grafting

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