Predictors of atrial fibrillation after conventional and beating heart coronary surgery: A prospective, randomized study

Raimondo Ascione, Massimo Caputo, Giliola Calori, Clinton T. Lloyd, Malcom J. Underwood, Gianni D. Angelini

Research output: Contribution to journalArticle

Abstract

Background - Atrial fibrillation (AF) increases the morbidity of CABG. The pathophysiology is uncertain, and its prevention remains suboptimal. This prospective, randomized study was designed to define the role of cardiopulmonary bypass (CPB) and cardioplegic arrest in the pathogenesis of this complication. Methods and Results - Two hundred patients were prospectively randomized to (1) on-pump conventional surgery [(100 patients, 79 men, mean age 63 (40 to 77) years)] with normothermic CPB and cardioplegic arrest of the heart or (2) off-pump surgery [(100 patients, 82 men, mean age 63 (38 to 86) years)] on the beating heart. Heart rate and rhythm were continuously monitored with an automated arrhythmia detector during the first 72 hours after surgery. Thereafter, routine clinical observation was performed and continuous monitoring restarted in the case of arrhythmia. The association of perioperative factors with AF was investigated by univariate analysis. Significant variables were then included into a stepwise logistic regression model to ascertain their independent influence on the occurrence of AF. There were no significant baseline differences between groups. Thirty-nine patients in the on-pump group and 8 patients in the off-pump group had postoperative sustained AF (P=0.001). Univariate analysis showed that CPB inclusive of cardioplegic arrest, postoperative inotropic support, intubation time, chest infection, and hospital length of stay were predictors of AF (all P

Original languageEnglish
Pages (from-to)1530-1535
Number of pages6
JournalCirculation
Volume102
Issue number13
Publication statusPublished - Sep 26 2000

Keywords

  • Cardiopulmonary bypass
  • Coronary disease
  • Fibrillation
  • Prevention
  • Tachyarrhythmias

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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    Ascione, R., Caputo, M., Calori, G., Lloyd, C. T., Underwood, M. J., & Angelini, G. D. (2000). Predictors of atrial fibrillation after conventional and beating heart coronary surgery: A prospective, randomized study. Circulation, 102(13), 1530-1535.