Ventral cardiac denervation and age related incidence of atrial fibrillation in patients undergoing CABG surgery compared to patients undergoing aortic valve surgery

Objective: Aim of this study was to compare the efficacy of ventral cardiac denervation (VCD) to prevent postoperative „de novo“ atrial fibrillation (PAF) in patients undergoing cardiac surgery for coronary artery disease and aortic valve disease. Methods: In 70 consecutive patients undergoing CABG surgery (group A1; n=39) and aortic valve surgery (group B1; n=31) VCD was performed. As control served 73 patients: undergoing CABG surgery (group A2; n=44) and aortic valve surgery (group B2; n=29) without VCD. All groups were similar for age, gender, NYHA class, left ventricular function and risk factors. All patients were free of atrial fibrillation before surgery. The same cardioplegia and cardiopulmonary bypass protocol were used in all cases. Denervation was performed before cardiopulmonary bypass. ECG by continous telemetry was monitored until postoperative day 3 and then daily control recorded until discharge. Results: In-hospital mortality was 0. The additional time for the surgical cardiac ventral denervation was approximately 5 minutes and there were no associated complications. VCD (%) (Group A1 and B1) No VCD (%) (Group A2 and B2) CABG surgery; age <65 years 42.9 53.3 CABG surgery; age >65 years 61.1 69.0 Aortic valve surgery; age <65 years 46.2 28.6 Aortic valve surgery; age >65 years 77.8 68.2 Conclusions: VCD is a no-risk procedure. Its use reduces the incidence of „de novo“ PAF after coronary surgery especially in patients older than 65, but seems to increase the rate of PAF after aortic valve operations.