The incidence of in-hospital atrial fibrillation after coronary artery bypass grafting using ventricular and atrial pacing

BACKGROUND: Atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery is a common problem. In this study, we sought to evaluate the safety and tolerance of continuous atrial pacing after CABG. We hypothesized that a strategy of temporary atrial pacing after CABG would reduce the incidence of postoperative AF. METHODS: During ۲۰۱۲, CABG candidates over ۱۸ years of age at Sina Hospital (Isfahan, Iran) were recruited. Before surgery, the participants were randomly assigned to two groups of ventricular pacing and left atrial ventricular pacing (atrial pacing). The primary end point of the study was the initial occurrence of AF or atrial flutter with a ventricular rate greater than ۱۰۰ beats per minute for ۱۰ consecutive minutes or completion of the ۴۸-hour monitoring period. RESULTS: We evaluated ۶۴ consecutive CABG candidates with sinus rhythm. They were allocated to two groups of ventricular pacing and atrial ventricular pacing (n = ۳۲ in each group). Three patients in the ventricular pacing group (۱۰%) and six in the atrial ventricular pacing group (۲۲%) had sustained AF during the first ۴۸ hours after CABG (P = ۰.۱۸ according to Fisher’s exact test). CONCLUSION: Continuous atrial pacing in the postoperative setting is safe and well-tolerated. In this study, we found that temporary atrial pacing increased the frequency of postoperative AF. Since the difference between the two groups was not significant, larger studies are required to determine the exact relation between pacing method and AF.   Keywords: Atrial Fibrillation, Coronary Artery Bypass Graft, Atrial Pacing