Off pump and on pump atrial fibrillation occuring effects of blood electrolyte values in coronary artery revascularization

Introduction: Atrial fibrillation is one of the most common postoperative complications in coronary arterial surgery. It is regarded as an important morbidity cause. Despite the advances in myocardial protection, surgical and anesthetic methods, atrial fibrillation can still be commonly seen. The literature cites a lot of risk factors. The use of cardiopulmonary bypass is one of the most accused factors. The purpose of this study is to analyze the relation between off pump/on pump coronary revascularization and atrial fibrillation.Materials and Methods: A total of 60 patients, consisting of 24 women and 36 men, have been included in our experiment. They have been divided into two equal groups of 30 people, according to whether they had been applied coronary revacularization using KPB (Group 1) or without using KPB on active heart (Group 2). The average age of the patients is 63.87 ± 10.02 years. The 60 patients who had either off pump or on pump coronary surgeries have been also followed retrospectively.Results: Regarding the influence of operations carried out with or without a pump, we were not able to find any significant (p=1.00) relation to the development of postoperative atrial fibrillation. However, the averaged out differences between the postoperative and preoperative potassium (0.68±0.81 and 0.2±0.77) and magnesium (10.6±9.52 and 4.23±1.69) variables, were found to be significant (p<0.05) according to the Student's t-test. On the other hand, there was no significant difference among the mean differences of urea, creatinine, Sodium, Calcium and Glucose variables (p>0.05).In patients operated by either on- or off pump, the Student's t-test revealed no important difference among the postoperative and preoperative values for urea, creatinine, Potassium, Sodium, Calcium, Magnesium and glucose variables (p>0.05).Comparing the differences in after variables for off pump coronary revascularization and for the atrial fibrillation, the differences in Potassium (0.74±0.72 and 0.1±0.67) and Calcium (0.9±0.62 and 0.02±0.55) serum levels were meaningful according to the Student's t-test (p<0.05). The average differences in the values and SDs for urea, creatinine, Sodium, Magnesium and glucose variables were, however, not meaningful (p>0.05).In conclusion, the frequencies of postoperative atrial fibrillation are similar when entering to an active heart on pump, or off pump. Electrolyte serum levels and their differences between preoperative and postoperative serum levels affect the development of postoperative atrial fibrillation. In our study, we found that there is a relation between the differences of Potassium and Magnesium levels and postoperative atrial fibrillation development in off pump and on pump coronary revascularization. Additionally, just like the effect of Potassium in postoperative atrial fibrillation, in off pump coronary revascularization Calcium levels have been found to play a significant role.Keywords. Off pump/on pump coronary artery bypass graft, atrial fibrillation, blood electrolites