Key result
Postoperative AF after CABG is linked to increased death and IABP use.
Why the study?
The effect of postoperative atrial fibrillation on outcomes after coronary artery bypass grafting is not clearly documented.
Does postoperative atrial fibrillation worsen the combined outcome of death and myocardial infarction in patients undergoing coronary artery bypass grafting?
Case-Control (n=263)
Does postoperative atrial fibrillation worsen the combined outcome of death and myocardial infarction in patients undergoing coronary artery bypass grafting?
Answers are grounded in this paper and cite their sources.
Postoperative atrial fibrillation following CABG is associated with significantly increased mortality and need for intraaortic balloon pump support, despite a non-significant increase in the composite of death and MI.
Introduction: Atrial fibrillation in postoperative period is common. Although the event of atrial fibrillation is associated with reduced cardiac output and its consequences and cerebrovascular events, its effect on outcome is not clearly documented. This study is done to evaluate the effect of atrial fibrillation on outcome of the operation. Materials and Methods: This is a retrospective case-control study. A total of 263 patients received coronary artery bypass grafting during this period. The data for demographics, comorbidities, preoperative medications, operative details, and echocardiographic parameters of left ventricular functions were acquired. A total of 24 patients had atrial fibrillation (Group I), while 239 remained in normal sinus rhythm (Group II). The outcome is measured as combined of death and postoperative myocardial infarction (MI). Results: The groups are comparable in demographic, preoperative medications, operative, and left ventricular parameters. Of the 24 (9.12%) patients who had postoperative atrial fibrillation, 11 were discharged on medical management. Nine patients reverted to sinus rhythm at discharge. Atrial fibrillation persisted in 8 patients 1 week after discharge and 3 patients after 1 month. The requirement of intraaortic balloon pump (IABP) was statistically significant in group I (5 in group I vs. 10 in group II, n = 0.001). There were 4 deaths in group 1 and 7 in group 2 (P = 0.002), however, the combined end point was achieved in 4 (16.6%) vs. 22 (9.2%), respectively, P = 0.1. Conclusion: The appearance of atrial fibrillation heralds increased requirement of IABP, MI, and death in patients undergoing coronary artery bypass grafting.
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Malhotra et al. (2021) conducted a case-control in Coronary artery bypass grafting (n=263). Postoperative atrial fibrillation vs. Normal sinus rhythm was evaluated on Combined of death and postoperative myocardial infarction (MI) (p=0.1). Postoperative atrial fibrillation after CABG was associated with increased death (P=0.002) and IABP use (P=0.001), while the combined death and MI endpoint occurred in 16.6% vs 9.2% (P=0.1).
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