Abstract 15924: Effect of Remote Ischemic Preconditioning on Post-Operative Atrial Fibrillation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Single-Center Randomized Controlled Trial
Introduction: Post-operative atrial fibrillation (POAF) is the most common arrhythmic complication after coronary artery bypass graft (CABG) and remains challenging to prevent, treat and is associated with adverse outcomes. Ischemic pre-conditioning with cross clamping of aorta has been shown to decrease ischemia- reperfusion induced arrhythmia following cardiac surgery. Remote ischemic pre-conditioning (RIPC), where another organ or skeletal muscle is subjected to brief periods of ischemia in order to achieve protective effect for the heart, has been associated with decreased cardiac enzyme release after elective percutaneous coronary intervention (PCI) and CABG. We aimed to study the effect of RIPC on the incidence of POAF after CABG.
Methods: We performed a prospective, single-center, single-blinded randomized controlled study of patients older than 18 years old undergoing elective CABG with or without valve surgery at our institution. Patients were randomized in a 1:1 fashion to treatment group (three sequential 5-minute sphygmomanometer cuff inflations alternating with 5 minute cuff deflation over right upper arm after induction of anesthesia) or control group (sphygmomanometer cuff placed on their right upper arm without inflation). The primary outcome was POAF lasting five minutes or longer during the first seven days after surgery. Secondary outcomes were length of hospital stay, incidence of myocardial infarction, stroke bleeding.
Results: Table 1
Conclusions: In this single-center randomized controlled study, RIPC did not decrease POAF after CABG. There were no statistically significant differences in any secondary outcomes following CABG, although the sample size was limited to finding only large group differences as significant. Larger, multi-center studies are needed to confirm this finding.
Author Disclosures: A. Lotfi: None. D. Engelman: None. H. Eftekhari: None. S. Sivalingam: None. M. Giannoni: None. A.R. Atreya: None. P. Visintainer: None.
- © 2014 by American Heart Association, Inc.