Pii: S1010-7940(01)00621-2

Objective: Atrial ®brillation (AF), the common postoperative complication, has been observed after coronary artery bypass grafting (CABG) in 7±40% of patients. Cardiopulmonary bypass (CPB), eliminated in off-pump operations (OPCABG) may decrease the incidence of AF, whereas the combination of CABG with heart valve replacement may result in more frequent postoperative atrial ®brillation. The aim of our study was to compare the early postoperative AF incidence rate during ICU stay in three groups of patients: after CABG, OPCABG, and CABG combined with valve replacement. Material and methods: A prospective study of 906 consecutive patients was carried out between January 1999 and January 2000. Clinical pro®le of 906 patients, including factors having potential in ̄uence on postoperative AF did not showed any signi®cant differences between the groups. The presence of arrhythmia history was the reason of excluding 85 patients from the statistical analysis. The observation was performed in each case during ICU-stay, using a HP system for continuos automated arrhythmia analysis. Early postoperative incidence of AF was recorded and compared between three groups of patients: 650 after conventional CABG, 118 after OPCABG, and 53 after CABG combined with valve replacement. Chi-square and a Mann±Whitney tests, Statistica 5.0 PL were used for the statistical analysis. Results: Atrial ®brillation occurred during the postoperative ICU stay in 9.8% of patients after CABG, in 10.2% after OPCABG, and in 21% after CABG combined with valve replacement. There was no signi®cant difference between CABG and OPCABG groups (P ˆ 0:965). The con®dence interval of the odds ratio ranges from 0.5 to 1.85. Consequently, an increased risk would be possible for both methods. We observed a statistically signi®cant increase of the early postoperative atrial ®brillation incidence rate in patients after CABG combined with valve replacement, when compared with both CABG 1 OPCABG groups (P ˆ 0:005). Conclusions: (1) Atrial ®brillation is a common postoperative complication after myocardial revascularization procedures which prolongs ICU stay. (2) The study did not show that the incidence of postoperative AF is in ̄uenced by the technique of coronary artery bypass grafting: with or without CPB. (3) The prevalence of postoperative AF increase when CABG is combined with valve replacement. q 2001 Elsevier Science B.V. All rights reserved.