Thoracic epidural anesthesia does not influence the incidence of postoperative atrial fibrillation after beating heart surgery

M Scherer, A S Sirat, T Aybek, S Martens, P Kessler, A Moritz
Thoracic and Cardiovascular Surgeon 2003, 51 (1): 8-10

BACKGROUND: At least 20 - 30 % of patients undergoing coronary artery bypass graft surgery (CABG) or beating-heart surgery develop postoperative atrial fibrillation (AF). We evaluated the effect of thoracic epidural anesthesia (TEA) on the occurrence of postoperative AF in patients submitted to CABG without cardiopulmonary bypass (OPCABG).

METHODS: We performed a retrospective analysis of 125 patients undergoing myocardial revascularization. Early postoperative incidence of AF was compared between three groups of patients - 50 after conventional CABG, 45 after OPCABG, and 30 after OPCABG combined with TEA intraoperatively and postoperatively. Clinical profile of the patients, including factors with a potential influence on postoperative AF was matched for groups.

RESULTS: Postoperative AF occurred in 13.3 % of the TEA-treated patients, in 17.7 % of the patients in the OPCABG group, and in 26 % of the patients in the CABG group. This difference did not carry any statistical significance. Risk factors and incidence of postoperative complications were comparable in all groups.

CONCLUSION: TEA has no effect on the incidence of postoperative AF in patients undergoing beating-heart surgery.

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