EFFECT OF POSTERIOR PERICARDIOTOMY IN REDUCING FREQUENCY OF ATRIAL FIBRILLATION IN POST OPERATIVE CORONARY ARTERY BYPASS GRAFTING SURGERY (CABG) PATIENTS IN PUNJAB INSTITUTION OF CARDIOLOGY LAHORE

Abstract

Postoperative atrial fibrillation (POAF) is a common complication following coronary artery bypass grafting (CABG), associated with increased morbidity, prolonged hospitalization, and higher healthcare costs. Posterior pericardiotomy, a surgical technique that facilitates the drainage of pericardial fluid into the pleural cavity, has been proposed as a preventive measure against POAF. Objective: To evaluate the effectiveness of posterior pericardiotomy in reducing the incidence of POAF in patients undergoing CABG at the Punjab Institute of Cardiology, Lahore, Pakistan. Methods: This randomized controlled trial included 94 patients undergoing CABG, randomized into two groups: Group A (posterior pericardiotomy) and Group B (control). Demographic data, POAF incidence, and postoperative outcomes were collected. Statistical analysis was conducted using SPSS version 20, with a p-value ≤0.05 considered significant. Results: The incidence of POAF was significantly lower in Group A (6.4%) compared to Group B (25.5%) (p=0.014). Group A also exhibited a shorter hospital stay (7.8 ± 1.4 days vs. 8.5 ± 1.6 days; p=0.021) and a lower incidence of pericardial effusion (4.3% vs. 21.3%; p=0.032). Both groups were comparable in baseline demographics and comorbidities. Conclusion: Posterior pericardiotomy significantly reduces the incidence of POAF, pericardial effusion, and hospital stay duration in CABG patients. These findings support its use as a safe and effective intervention to improve postoperative outcomes in resource-limited settings like Pakistan.