Atrial fibrillation (AF) is the most common arrhythmia following coronary artery bypass grafting (CABG) and it increases morbidity and mortality associated with this procedure. The purpose of this study was to evaluate the predictability of this arrhythmia using previously identified risk factors and to assess the efficacy of recommended prophylactic beta blocker (BB) therapy in the prevention of post CABG AF.
We performed a retrospective chart analysis of consecutive patients undergoing elective CABG during 1 year period. Patients who developed new onset AF after the surgery were designated as cases and those who did not, as controls. 41 different variables were analyzed using Chi-square test and independent sample t-test. Multivariate analysis was carried out using logistic regression model.
23% patients undergoing CABG developed AF during post-operative period. Statistically significant differences were observed between the two groups in terms of age, use of preoperative aspirin, current smoking, history of AF, size of left atrium, history of congestive heart failure (CHF) and brain natriuretic peptide (BNP) levels. In terms of prophylactic therapy, preoperative BB did not independently protect against post CABG AF. On multivariate analysis, only age, use of Aspirin (ASA) and history of AF remained as independent predictors of post CABG AF.
In conclusion, we found that the use of BB before CABG did not independently decrease the risk of postoperative AF. Age, preoperative ASA and history of AF were stronger independent predictors of post operative AF.
Credits: Muhammad F Khan, M.D; Aravind Herle, M.D; Mohammad Reza Movahed, M.D, Ph.D