Reduced incidence of atrial fibrillation with minimally invasive direct coronary artery bypass

Background. Atrial fibrillation (AF) is a frequent complication after coronary artery bypass graft (CABG) surgery. The purpose of this study was to determine the incidence of postoperative AF after minimally invasive direct coronary artery bypass (MIDCAB) in comparison with CABG. Methods. Between November 1995 and May 1997, 96 MIDCAB procedures were performed. During the same period, 42 patients underwent traditional single CABG using the left internal mammary artery graft (S-CABG). The incidence of in-hospital AF, defined as a sustained episode requiring treatment, was compared between the two groups. Results. There was no difference in age, ejection fraction, or preoperative risk score between the groups. The use of β-blockers before or after surgery was not different. The incidence of postoperative AF in the first 6 weeks after surgery was 4% (4 of 96) for MIDCAB and 28% (12 of 42) for S-CABG (p = 0.003). Patients with postoperative AF were older than those without AF (AF 75.5 ± 13.2, non-AF 64.4 ± 10.9, p = 0.005). MIDCAB patients had a shorter hospital stay (4.0 ± 1.2 versus 7.0 ± 5.1 days, p< 0.05). Increased hospital stay attributable to AF was 0.6 ± .5 days for MIDCAB and 0.9 ± .2 days for S-CABG patients. There were no hospital deaths in either group. Conclusions. The incidence of postoperative AF after single vessel bypass surgery is reduced to a very low level after MIDCAB in comparison with CABG.