OBJECTIVE: Postoperative atrial fibrillation (AF) is still frequent complication after
coronary bypass surgery in spite of the improvements in the surgical procedures. There
is still controversy whether or not, the absence of cardiopulmonary bypass results in a
lower incidence of AF.
METHODS: One hundred and fifty one patients that underwent revascularization by a
single surgeon were included in this retrospective study and the patients were divided in
two groups. Group I included 74 patients who underwent complete revascularization
with cardiopulmonary bypass and group II consisted of 77 patients who underwent
complete revascularization without cardiopulmonary bypass. The incidence and predictive
perioperative factors of AF in two groups were determined and compared.
RESULTS: There were no significant differences between two groups with respect to the
preoperative demographic characteristics of the patients. The incidence of postoperative
AF was determined as 2.8% after on-pump and 0.7% after off-pump revascularization.
Avoiding cardiopulmonary bypass did not decrease the incidence of postoperative AF.
The rates of AF in both groups were decreased by using prophylactic ß-blocker usage
(P=0.05 in group I, P<0.001 in group II).
CONCLUSION: There is no reduction of AF rate in myocardial revascularization without
cardiopulmonary bypass. However, prophylactic ß-blocker usage decreases the incidence
of AF after both on-pump and off-pump myocardial revascularization.
KEY WORDS : CABG; Atrial Fibrillation; CABG Complication
Atrial Fibrillation (AF) is a supraventricular arrhythmia characterized by uncoordinated
atrial activation with consequent deterioration of atrial mechanical function. On the
electrocardiogram (ECG), AF is manifested by the replacement of consistent p waves by
rapid oscillations or fibrillatory waves that vary in size, shape and timing, associated with
an irregular, frequently rapid ventricular response when atrioventricular (AV) conduction
is intact. Fast AF is defined as A