The effect of metoprolol during rewarming on the incidence of atrial fibrillation in patients undergoing coronary artery bypass grafting

Abstract

Background: Atrial fibrillation is one of the most common arrhythmia in heart surgery. The aim of this study was to evaluate the effect of metoprolol injection during rewarming on the incidence of postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting. Methods: This study was performed as a double-blind clinical trial in the cardiac operating room and intensive care unit (ICU) in Chamran hospital, Isfahan, Iran, in patients undergoing non-emergency coronary artery bypass graft surgery. Patients were randomly divided into two groups of 43 patients as case and control groups. The metoprolol group received 10 mg intra-oxygenator metoprolol in rewarming period of cardiopulmonary bypass (CPB), and the case group received 10 cc placebo at the same time. Both groups were monitored during and after surgery. Findings: The frequency of patients with atrial fibrillation was 25 and 4.7 in the control and intervention groups, respectively. The mean duration of ICU hospitalization was 2.98 and 2.24 days in the control and intervention groups, respectively, with significant difference (P < 0.050). The need to inotrope or antiarrhythmic drugs and shock therapy did not show significant difference between the groups (P > 0.050). Conclusion: According to our findings, it seems that metoprolol injection during coronary artery bypass grafting can significantly reduce the frequency of atrial fibrillation and the length of ICU stay. © 2021 Isfahan University of Medical Sciences(IUMS). All rights reserved.