What question did this study set out to answer?

To determine whether avoiding cardiopulmonary bypass reduces the incidence of postoperative atrial fibrillation in patients undergoing surgical revascularization for single-vessel disease.

September 29, 2004European Journal of Cardio-Thoracic Surgery

Atrial fibrillation after surgical revascularization: is there any difference between on-pump and off-pump?

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Why the study?

Does off-pump surgical revascularization reduce the incidence of postoperative atrial fibrillation compared to on-pump revascularization in patients with single vessel disease?

Population

670 patients undergoing revascularization using in situ LIMA for single vessel disease

Comparison

Complete revascularization without… vs Complete revascularization with cardiopulmonary…

Design

Cohort

Follow-up

postoperative period

Authors

YEYavuz EnçNature Conservation Centre

Discussion

Member takes

Implication

Avoiding bypass was not associated with lower AF rates in this cohort; leaves open whether randomized trials would confirm equivalence.

Key Points

To determine whether avoiding cardiopulmonary bypass reduces the incidence of postoperative atrial fibrillation in patients undergoing surgical revascularization for single-vessel disease.
Retrospective analysis of 670 patients undergoing revascularization using an in situ left internal mammary artery for single-vessel disease.
Patients were grouped into on-pump complete revascularization with cardiopulmonary bypass (Group I, n=328) and off-pump complete revascularization without cardiopulmonary bypass (Group II, n=342).
Incidence and independent perioperative predictive factors of postoperative atrial fibrillation were compared between groups.
Postoperative atrial fibrillation occurred in 16.1% of on-pump patients compared to 14.6% of off-pump patients, demonstrating no significant reduction from avoiding cardiopulmonary bypass.
Predictive factors for atrial fibrillation included sex, age >65 years, prophylactic beta-blocker usage, and left ventricular dysfunction in Group I (r²=0.51, P<0.001), whereas only age >65 years and prophylactic beta-blocker usage were predictive in Group II (r²=0.59, P<0.01).
Prophylactic beta-blocker use significantly decreased atrial fibrillation rates in both on-pump (P=0.05) and off-pump groups (P<0.001).

Structured PICO

Does off-pump surgical revascularization reduce the incidence of postoperative atrial fibrillation compared to on-pump revascularization in patients with single vessel disease?

Population

670 patients undergoing revascularization using in situ LIMA for single vessel disease

Intervention

Complete revascularization without cardiopulmonary bypass (off-pump) (n=342)

Comparator

Complete revascularization with cardiopulmonary bypass (on-pump) (n=328)

Outcome

Incidence of postoperative atrial fibrillationhard clinical

Avoiding cardiopulmonary bypass during surgical revascularization does not reduce the incidence of postoperative atrial fibrillation, though prophylactic beta-blockers are effective in both approaches.

Cite This Study

Yavuz Enç (2004) studied this question.

synapsesocial.com/papers/6a819fbd5fe02a08f3d82079 https://doi.org/10.1016/j.ejcts.2004.07.029

Topics

Atrial fibrillation Persistent AF management Hypertension management Anticoagulation in AF AF ablation outcomes

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Atrial fibrillation after surgical revascularization: is there any difference between on-pump and off-pump?

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Atrial fibrillation after surgical revascularization: is there any difference between on-pump and off-pump?

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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