272 The Use of Epicardial Pacing Lead as a Prophylaxis for Atrial Fibrillation Post Coronary Artery Bypass Surgery

Abstract

Abstract Aim Patients undergoing cardiac surgery are at risk for developing postoperative atrial fibrillation (AF), a complication linked to increased morbidity, extended hospital stays, and significant healthcare costs. Epicardial pacing has emerged as a preventive strategy for postoperative AF, though its effectiveness and optimal application are still under active investigation. Method A review of multiple studies was conducted to assess the impact of epicardial pacing on reducing postoperative atrial fibrillation (AF) in cardiac surgery patients. Data on AF incidence, hospital stay duration, and healthcare costs were evaluated to determine the effectiveness of pacing as a preventive measure. Postoperative outcomes and complication rates were also analysed to provide a comprehensive assessment of epicardial pacing's role in patient recovery and overall care efficiency. Results Epicardial pacing demonstrated notable reductions in post-operative AF, with biatrial pacing (BAP) showing superior efficacy. A study observed that patients receiving atrial pacing after CABG exhibited a significant decrease in AF incidence from 27% to 10%. Similarly, another study found that BAP significantly reduced AF incidence to 12.5%, compared to 36.4% with left atrial pacing, 33.3% with right atrial pacing (RAP), and 41.9% in controls. BAP was also associated with shortened hospital stays (mean reduction of 2.6 days) and a 14% decrease in. Conclusions Epicardial pacing offers a highly effective strategy for reducing AF incidence and associated complications following CABG. By decreasing hospital stays and lowering healthcare costs, epicardial pacing can enhance recovery outcomes for high-risk patients. Further research to refine pacing protocols could help optimize its application.