Atrial septal pacing in prevention of atrial fibrillation after coronary arterial bypass graft in the high-risk patients

Atrial fibrilation is the most often heart rhythm disorder and the most often cause of hospitalization due to the heart rhythm disorder. The incidence of atrial fibrillation after coronary artery bypass graft varies from 25 to 30%, while it significantly grows if along with the existing operation, there is a significant valvulary failure, which is resolved with the operation. So far poor results of atrial fibrillation treatment after coronary arterial bypass graft require new approaches in resolving of this problem. The aim of the work was to examine the efficiency of interatrial pacing in prevention of the atrial fibrillation after coronary arterial bypass graft in the high-risk patients. The patients were separated in two groups: those who were applied atrial septal pacing (group A) and those without pacing (group B). There were 30 patients in each group. The conditions for including were: over 60 years of age, right coronary artery stenosis higher than 50%, preoperative sinus rhythm and ejection fraction of the left ventricle lower than 40%. The patients in Group A had epicardial electrode positioned during, the operation in the Cox's triangle and the stimulation was performed with frequency 10% higher than the spontaneous, up to maximum 110 per minute. The patients in the Group V had only the electrode positioned, but stimulation was not performed. The stimulation commenced on the fourth hour of the postoperative treatment and lasted continuously for the following 96 hours. The results have shown statistically significantly higher incidence of atrial fibrillation in the group without pacing, due to which the hospitalization was significantly longer thus also the cost of the treatment. In the high-risk patients atrial septal pacing is safe and efficient in prevention of atrial fibrillation after coronary arterial bypass graft.