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Brazilian Journal of Cardiovascular Surgery
On-line version ISSN 1678-9741
AVILA NETO, Vicente et al. Effect of temporary right atrial pacing in prevention of atrial fibrillation after coronary artery bypass graft surgery. Rev Bras Cir Cardiovasc [online]. 2007, vol.22, n.3, pp.332-340. ISSN 1678-9741. http://dx.doi.org/10.1590/S0102-76382007000300010.
OBJECTIVE: To evaluated the effects of temporary atrial pacing to prevent the atrial fibrillation after coronary artery bypass graft surgery and the risk factors to the occurrence of this arrhytmia. METHODS: We have studied 160 patients who, at the end of coronary artery bypass graft surgery, were submitted to epicardial electrode implantation in the right atrium lateral wall. They were randomized into two groups: non-pacing (NP) group and right atrial (RA) pacing group. The cardiac rhythm was monitorized over 72 hours following to the end of surgery and the variables studied were as follow: incidence of atrial fibrillation; the risk factors pre-, intra-, and postoperative for its occurrence, and postoperative events. RESULTS: There were 21 (13.1%) episodes of atrial fibrillation, 20 in NP group and one in RA group. The relative risk (RR) for development of atrial fibrillation was 0.18 (95% CI; 0.05-0.60) for the RA group when compared to the NP group. The logistic regression identified that the study variables, such as younger age; use of beta-blockers in the preoperative, and the presence of right atrial pacing had been associated to a lower Odds ratios (ORs) for the occurrence of atrial fibrillation in the postoperative. CONCLUSIONS: The temporary atrial pacing reduced the incidence of atrial fibrillation after the CABG surgery. Older age and a non-atrial pacing were the independent predictive factors of the occurrence of this arrhythmia.
Keywords : Cardiac pacing, artificial; Atrial fibrillation; Myocardial revascularization; Postoperative complications; Extracorporeal circulation.