Ventral cardiac denervation reduces the incidence of atrial fibrillation after coronary artery bypass grafting

(the journal of thoracic and cardiovascular surgery volume - 2004, 2004;127:511-6: )

Objectives: Because the autonomic nervous siystem is an important determinant in the appearance of atrial fibrillation, qe have assesed the role of ventral cardiac denervation for its prevention. Methods: Patients undergoing low-risk coronary artery surgery were enrolled. No routine antiarrhythmic drugs were administered before cardiopulmonary bypass. The groups were comparable regarding demographic, clinical, and operative variables. Results: The additional time for the denervation was 5±2 minutes, and there were no associated complications. Postoperative atrial fibrillation was present in 15 (7%) patients undergoing ventral cardiac denervation (95% confidece interval, 4%-12%) and in 56 (27%) control subjects (95% confidence interval, 18%-35%). Patients submitted to ventral cardiac denervation had fewerand less severe episodes of atrial fibrillation, and no patient had atrial fibrillation after discharge. Ventral cardiac denervation was the most significant predictor of postoperative atrial fibrillation (odds ratio, 0.42; confidence interval, 0.23-0.78; p=.006). Age of greater than 65 years (odds ratio, 1.67; confidence interval, 0.96-2.9; p=.067) was a highly suggestive predictor. The analysis of the effect of ventral cardiac denervation correlated with the patient’s age showed a more pronounced effect in patients younger than 70 years (odds ratio, 0.43; confidence interval, 0.22-0.86; p=.022). Conclusions: Ventral cardiac denervation is a fast and low-risk procedure. Its use significantly reduces the incidence and severity of atiral fibrillation after routine coronary artery bypass surgery. Patients younger than 70 years of age are expected to have a higher success rate than those older than 70 years.