Prophylactic ventral cardiac denervation: Does it reduce incidence of atrial fibrillation after coronary artery bypass grafting?

Objective

This study assessed the prophylactic effect of ventral cardiac denervation on reducing atrial fibrillation after coronary artery bypass grafting.

Methods

This randomized prospective study recruited 220 adult patients (aged 42–79 years) who were scheduled to undergo coronary artery bypass grafting. Of these patients, 110 underwent ventral cardiac denervation in addition to coronary artery bypass grafting and 110 underwent only coronary artery bypass grafting. The demographic, intraoperative, and postoperative factors comprising atrial fibrillation were compared between the 2 groups. In addition, the predictive factors of atrial fibrillation in all 220 cases were assessed.

Results

The mean age and the distribution of gender, body mass index, diabetes mellitus, chronic obstructive pulmonary disease, hypertension, hypercholesterolemia, and left main disease were not significantly different between the 2 groups. Atrial fibrillation incidence was significantly different between the groups (P=.025), with an incidence of 20.9% in the ventral cardiac denervation group and 10% in the control group. Atrial fibrillation occurred in 34 of the 220 patients, and ventral cardiac denervation was considered as a variable to evaluate its possible role in the prevention of postoperative atrial fibrillation. Our multivariate analysis showed age (P=.002; odds ratio,1.098; confidence interval, 1.034–1.165) and ventral cardiac denervation (P=.044; odds ratio,2.32; confidence interval, 1022–5.298) as the predictive factors of atrial fibrillation after coronary artery bypass grafting.

Conclusions

Given the surprising results of the present study demonstrating that ventral cardiac denervation is a predictive factor of atrial fibrillation after coronary artery bypass grafting, ventral cardiac denervation should not be routinely considered for the prevention of atrial fibrillation after coronary artery bypass grafting.

Abbreviations and Acronyms: AF, atrial fibrillation, CABG, coronary artery bypass grafting, CPB, cardiopulmonary bypass, ECG, electrocardiography, ICU, intensive care unit, VCD, ventral cardiac denervation