Comparing the outcome of on-pump versus off-pump coronary artery bypass grafting in patients with preoperative atrial fibrillation

Around 5-15% of patients undergoing coronary artery bypass grafting (CABG) suffer from preoperative/pre-existing atrial fibrillation (PAF). This is a benign arrhythmia but can affect the outcome of the surgery. The aim of this study was to assess the effect of PAF on the immediate postoperative course of patients undergoing on-pump (ONCAB) vs. off-pump (OPCAB) CABG. Over a 10-year period, data were prospectively entered into the database of our institution. A total of 10,461 patients underwent CABG, of whom 477 (4.6%) were in PAF. We analyzed these patients in two separate groups: group A (n=310) who underwent ONCAB and group B (n=167) who underwent OPCAB. After 4:1 propensity matching and adjusting for the preoperative and operative characteristics of these two groups with patients in SR (sinus rhythm), early, mid- and long-term outcomes of PAF patients were analyzed. After adjusting for preoperative characteristics, postoperative complications were significantly higher in patients who had ONCAB when there was PAF compared to those in SR (P