Factors Associated With Postoperative Arrhythmias in Patients Undergoing Isolated Off-Pump Coronary Artery Bypass Grafting: A Single-Center Prospective Observational Study

Background and aim Postoperative arrhythmia is very common after isolated coronary artery bypass grafting (CABG). Indeed, it is the most frequently encountered arrhythmia and an important contributor to postoperative morbidity and mortality. This study aimed to evaluate the incidence of postoperative arrhythmias and to identify factors associated with their occurrence in patients undergoing isolated off-pump CABG. Methods This prospective observational study was conducted on 100 patients who underwent isolated CABG at Bhanubhai and Madhuben Patel Cardiac Centre from January 2020 to September 2021. Demographic and hemodynamic data were recorded intraoperatively and postoperatively. The primary outcome was postoperative arrhythmia, and atrial fibrillation was analyzed as a subtype. Bivariate analysis followed by multivariate logistic regression was performed to identify factors associated with postoperative arrhythmia. Adjusted odds ratios (OR) with 95% confidence intervals (CI) were reported. Results The incidence of postoperative arrhythmia was 23%, of which atrial fibrillation occurred in 17% and ventricular premature complexes in 6% of patients. Univariate analysis revealed that age, diabetes mellitus, and intraoperative bradycardia were associated with the occurrence of arrhythmia. On multivariate logistic regression, diabetes mellitus (OR 3.31; 95% CI 0.97-11.27), intraoperative bradycardia (OR 4.76; 95% CI 1.06-21.27), and intraoperative tachycardia (OR 8.89; 95% CI 1.09-72.27) were associated with postoperative arrhythmia. Conclusions Diabetes mellitus and intraoperative hemodynamic variations were associated with postoperative arrhythmias in patients undergoing off-pump CABG. These findings represent associative relationships and should be interpreted cautiously given the observational design and limited sample size.