BackgroundPostoperative atrial fibrillation (POAF) is the most common complication associated with higher mortality rates, prolonged hospitalization, and increased treatment costs.The aimof this cross-sectional longitudinal study is to compare the incidence of POAF after coronary artery bypass grafting (CABG) performed with different surgical techniques. The primary outcome is defined as a heart rhythm disorder with atrial fibrillation characteristics that lasts longer than 5 min or requires treatment due to clinical instability.MethodsThe study included 229 hemodynamically stable patients with isolated coronary artery disease who underwent elective CABG. 153 patients underwent CABG with use of cardiopulmonary bypass (ONCAB) and 76 patients without it (OPCAB). In the preoperative risk assessment with modified score, the risk of POAF was higher in the ONCAB group.ResultsPOAF occurred in 86 (37.55%) of a total 229 patients. The number of new cases of POAF is lower in the OPCAB 36 (15.72%) compared to 50 (21.83%) in the ONCAB group (p = 0.031). In the postoperative period there was a significant difference in the time of onset of the primary outcome, the time spent in the IUC and the length of hospitalization.ConclusionPOAFs are more common in ONCAB operating technique. The OPCAB technique reduces postoperative complications, shortens the stay in the IUC and the length of hospitalization, and reduces treatment costs.

Introduction: Postoperative Atrial Fibrillation (POAF) is associated with a higher rate of postoperative complications and mortality, as well as with longer hospitalization and increased treatment costs. We have designed and performed a randomized, trial of pharmacological prophylaxis in which the event of interest is POAF. Aim: The aim of this study is to reduce the risk of postoperative, complications associated with this arrhythmia. Methods: We included 240 stable patients with a coronary heart disease, who were referred to elective surgical revascularization of the myocardium. The patients were assigned into three groups of 80 patients each: group A (BB, beta blocker, comparator), group B (BB+ Amiodarone) and group C (BB + Rosuvastatin). The goal was to establish whether intervention by combination therapy was more useful than a comparator. Results: An event of interest (POAF) has occurred in 66 of the total 240 patients. Number of new POAF cases is the lowest in Group B, 14 (17.5%) compared to 25 (31.25%) new cases in the comparator group, and 27 new cases (33.75%) in group C. Absolute risk reduction was 13.75%, ≈14% less POAF in group B compared to comparator. Relative risk reduction was 56% (RR 0.56, p = 0.04). Number Needed to Treat was 7.27. In group C, 33.75% of patients developed POAF. Absolute risk was insignificantly higher in group C (2.5%, NS) compared to the comparator .The number needed to harm was high, 40. Conclusion: The results of our research show that prophylaxis of POAF with combined therapy BB + Amiodarone was the most efficient one.