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Ann Thorac Surg 2005;79:517-520
© 2005 The Society of Thoracic Surgeons

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Original article: Cardiovascular

Evaluation of Ventral Cardiac Denervation As a Prophylaxis Against Atrial Fibrillation After Coronary Artery Bypass Grafting

Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull, United Kingdom

Accepted for publication August 4, 2004.

^* Address reprint requests to Dr Alex, The Cottage, Main Road, Covenham, St Bartholomew, Louth, LN11 0PF, UK (E-mail: mrjosephalex{at}yahoo.co.uk).

BACKGROUND: To evaluate the efficacy of ventral cardiac denervation as a prophylaxis against post-coronary artery bypass grafting (CABG) atrial fibrillation (AF).

METHODS: Seventy consecutive patients who underwent CABG (group A) were compared to 70 consecutive subsequent patients who underwent CABG + ventral cardiac denervation (group B). Both groups were well-matched for age, gender, disease severity, LV function, Euro scores, Parsonnet scores, preoperative ß-blockers, Ca-channel blockers, digoxin, and angiotensin converting enzyme inhibitors. The same cardioplegia, bypass, and operation techniques were used in all cases. Denervation before initiating bypass increased operation time by approximately 5 minutes. Heart rate and rhythm were monitored by continuous telemetry until postoperative day 5 and then 4- hourly until discharge.

RESULTS: The cross-clamp time (p = 0.6), bypass time (p = 0.1), number of grafts (p = 0.9), inotrope usage (p = 0.4), reexploration rate (p = 1), postoperative myocardial infarction (none in either group), blood loss (p = 0.7), and length of stay (p = 0.8) were comparable in both groups. There was no significant difference in the incidence of AF; 34% in group A versus 29% in group B (p = 0.3).

CONCLUSIONS: Ventral cardiac denervation failed to significantly reduce the incidence of AF following coronary revascularization in our study.

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