Atrial fibrillation after Coronary Artery Bypass Surgery with and without Cardiopulmonary Bypass

Background:Atrial fibrillation (AF) is the most common postoperative supraventricular arrhythmi. 20%
to 40% of patients have AF after coronary artery bypass operation (CABG).Arrhythmia of all grades may
occur due to cardiopulmonary bypass (CPB) and injuries inflicted during operativeprocedures. Thus it has
been proposed that CABG surgery would be safer if CPB could be avoided.
Methods:Total 60 patients who underwentCABG were selected for the study and divided in two groups.
Group A: 30 patients with Off-pump CABG (OPCAB) and Group B: 30 patients with On-pump CABG. 12
lead ECG was done at morning on the day of surgery, after surgery & when any arrhythmia are noted for
at least 7days. Morbidity of patients like arrhythmia and hospital mortality were recorded and compared
during the first week after surgery.
Results:Off-pump group (group- A) had less incidence of post-operative AF than on-pump group(group-B)
(10% vs 40%). Postoperative blood requirement,total operative time, the period of mechanical ventilation,ICU
stay and total postoperative hospital stayis significantly shorter in off-pump than in on-pump group of
patients.
Conclusion: This study clearly demonstrates that off pump CABG procedure is associated with less
incidence of AF. Therefore OPCAB procedure for myocardial revascularization is clearly justified whenever
feasible.