Impact of Posterior Pericardiotomy on Prevention of Post Operative Atrial Fibrillation in Patients Undergoing Coronary Bypass Surgery
Mostafa Elhelali, Eslam Elhelw, Rami Ahmed Sabri, Amir Bastawisy
Cardiology and Angiology: An International Journal · pp. 139–147 · Published 31 May 2024
10.9734/ca/2024/v13i2416Abstract
Purpose: Coronary artery bypass grafting surgery (CABG) is a common surgical procedure used to treat coronary artery disease (CAD). Despite advancements in the surgical techniques and perioperative care, cardiac surgery patients remain at risk of developing complications, especially atrial fibrillation (AF), The present study aimed to investigate the impact of posterior pericardiotomy on the incidence of postoperative AF and other relevant complications following CABG. Methods: This study is a randomized controlled trial conducted at a single center. A total of 204 patients were randomly assigned to two groups: the pericardiotomy group and the non-pericardiotomy group (control group). The study assessed the incidence of postoperative atrial fibrillation within the first 7 days following CABG surgery. Results: Our findings revealed no statistically significant difference in the incidence of pericardial effusion and AF between the pericardiotomy and non-pericardiotomy groups. The lack of cardiopulmonary bypass (CPB) in the on-pump CABG method may have contributed to the absence of significant differences in pericardial effusion rates between the groups. Moreover, we found that posterior pericardiotomy did not significantly affect the intubation time, length of stay in the intensive care unit (ICU), and total hospital stay in either group. Our study differs from previous research that focused on off-pump CABG patients. Studies that utilized CPB reported a significant reduction in pericardial effusion and arrhythmias with posterior pericardiotomy. This discrepancy suggests that the use of CPB may play a crucial role in the occurrence of arrhythmias and subsequent complications. Conclusions: our study indicates that posterior pericardiotomy did not significantly influence the incidence of pericardial effusion and AF in on-pump CABG patients. Considering the differences in surgical techniques and patient populations, further research with larger sample sizes is warranted to provide more definitive insights into the role of posterior pericardiotomy in this specific setting. Comprehensive studies will be instrumental in guiding clinical decisions and establishing best practices for the prevention of postoperative pericardial effusion and arrhythmias in on-pump CABG patients.
References (19)
- 1 Postoperative atrial fibrillation: mechanisms, manifestations and management [DOI]
- 2 Postoperative atrial fibrillation following cardiac surgery: a persistent complication [DOI]
- 3 Postoperative atrial fibrillation: from mechanisms to treatment [DOI]
- 4 Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery: an adaptive, single-centre, single-blind, randomised, controlled trial [DOI]
- 5 Pericardial Blood as a Trigger for Postoperative Atrial Fibrillation After Cardiac Surgery [DOI]
- 6 Postoperative Atrial Fibrillation Following Cardiac Surgery: From Pathogenesis to Potential Therapies [DOI]
- 7 Pericardial Effusion Provoking Atrial Fibrillation After Cardiac Surgery [DOI]
- 8 Meta-analysis of randomized trials on the efficacy of posterior pericardiotomy in preventing atrial fibrillation after coronary artery bypass surgery [DOI]
- 9 Factors influencing postoperative atrial fibrillation in patients undergoing on-pump coronary artery bypass grafting, single center experience [DOI]
- 10 Examining the impact of active clearance of chest drainage catheters on postoperative atrial fibrillation [DOI]
- 11 Posterior pericardiotomy for the prevention of atrial fibrillation after coronary artery bypass grafting: A meta-analysis of randomized controlled trials [DOI]
- 12 Posterior pericardiotomy to prevent new-onset atrial fibrillation after coronary artery bypass grafting: a systematic review and meta-analysis of 10 randomized controlled trials [DOI]
- 13 Postoperative pericardial effusion, pericardiotomy, and atrial fibrillation: An explanatory analysis of the PALACS trial [DOI]
- 14 Characteristics of Postoperative Atrial Fibrillation and the Effect of Posterior Pericardiotomy [DOI]
- 15 Pericardial Inflammatory Mediators That Can Drive Postoperative Atrial Fibrillation in Cardiac Surgery Patients [DOI]
- 16 Posterior Left pericardiotomy for the prevention of postoperative Atrial fibrillation after Cardiac Surgery (PALACS): study protocol for a randomized controlled trial [DOI]
- 17 Management of postoperative atrial fibrillation after cardiac surgery [DOI]
- 18 Can Posterior Pericardiotomy Reduce the Incidence of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting? [DOI]
- 19 Posterior left pericardiotomy for the prevention of atrial fibrillation: evidence from the PALACS trial [DOI]
Cited by 4
Ismail Al-Shameri, Abudar A. Al-Ganadi, Mahdi A. Kadry · The Heart Surgery Forum · 2025
Muneeb Khawar, Syed Abdullah Shah, Ayesha Khan · World Journal of Cardiology · 2025
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