The Evaluation of Right Atrial Temporary Pacing for Preventing Postoperative Atrial Fibrillation Following Coronary Artery Bypass Grafting Surgery: prospective observational study

Abstract: Atrial fibrillation (AF) is the most frequent (arrhythmia) complication following coronary artery bypass grafting surgery (CABG). The present study is designed to evaluate the efficacy of temporary atrial pacing in the prevention of AF after off pump coronary artery bypass graft surgery. The patients who had first-time off-pump CABG were enrolled in the study. The exclusion criteria were that the patients had valve dysfunctions. The study group (n = 39) were paced electively and the control group (n = 40) were not paced, and both were monitored for 96 hours postoperative for the occurrence of AF. The end points of the study were occurrence of AF, death during postoperative period, and discharge from hospital. The data analyzed by t-test and chi-squared test for variables. A total of 120 patients enrolled in the study. Forty-one patients were excluded from the study because of intraoperative dysrhythmia, tachycardia or failure of pacing, so the final study subjects consist of 79 patients. AF occurred in 13 of 39 paced group (33.33%) and 13 of 40 non-paced group (32.5%). No statically significant difference in the proportion of patients developing atrial fibrillation was observed between the study and the control group for incidence of AF. Old age (P=0.007), history of myocardial infarction (P=0.001), systolic dysfunction (P=0.003), ejection fraction (P=0.022) and atrial enlargement (P=0.001) were identified as AF predictors. The result of this study shows that prophylactic right atrial pacing had no significant effect on reducing the incidence of AF following off-pump CABG