Abstract
Objective. Tachyarrhythmias, after coronary artery bypass graft (CABG) surgery, develop in 11%–40% of patients. Surgery technique (on-pump or off-pump) might affect incidence of post-CABG tachyarrhythmias. Methods. The study included 60 patients undergoing CABG (≥2 grafts) with left ventricle ejection fraction (LV EF) >40%. Patients were divided into two groups equally: group A (on-pump) and group B (off-pump). Patients were subjected to electrocardiographic monitoring (7 days postoperatively), transthoracic echocardiography, with recording of surgical details and complications. Results. Data collected between December 2012 and May 2013 showed no significant difference between two groups regarding incidence of postoperative tachyarrhythmias with statistically significant higher incidence of supraventricular tachycardia in group B (P<0.05) and a trend towards higher incidence of atrial fibrillation in group A. Patients who developed postoperative tachyarrhythmias in group A showed higher prevalence of family history of coronary artery disease and higher incidence of postoperative chest infections (P<0.05), while those in group B showed higher mean LV EF (pre- and postoperatively) (P<0.05). Data were statistically described in terms of mean ± standard deviation. Comparison of numerical and categorical variables was done using Student’s t- and Chi-square tests, respectively. Conclusion. Adopting off-pump CABG technique is not associated with less incidence of post-operative tachyarrhythmias, as compared to on-pump technique.
Highlights
Surgery for coronary artery disease is known as coronary artery bypass graft (CABG) surgery
Patients were considered eligible for inclusion if they were undergoing first time CABG, with preoperative transthoracic echocardiography (TTE) showing left ventricle ejection fraction (LV EF) >40%, left atrial anteroposterior diameter
Before inclusion, informed written consent was obtained after explanation of study protocol that was approved by our local institutional human research committee as it conforms to the ethical guidelines of the 1975 Declaration of Helsinki, as revised in 2008
Summary
Surgery for coronary artery disease is known as coronary artery bypass graft (CABG) surgery. It was first performed in 1967 by Kolesov and is still the leading heart operation performed today [1]. Surgeons use cardiopulmonary bypass machine ( known as the heart-lung machine) for onpump CABG [2]. Complications of on-pump CABG, especially stroke and decrease in higher mental functions, spurred the development of off-pump technique [1]. Up to 30% of patients develop atrial fibrillation (Af) after CABG, mostly benign and self-terminating. Patient selection plays an important role in success of off-pump CABG (OPCAB). Patients with poor ejection fraction, cardiomegaly, cardiogenic shock or malignant arrhythmias are at high risk for OPCAB [4]
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