Research Article

The Effect of Dexmedetomidine on the Incidence of Atrial Fibrillation after Coronary Artery Bypass Graft Surgery


Background: Atrial fibrillation (AF) may occur in patients after coronary artery bypass surgery (CABG). Dexmedetomidine is a selective agonist of the alpha-2 adrenergic receptor with sedation, anti-anxiety and analgesic effects.
Therefore, the aim of the present study was to investigate the effect of sedation with dexmedetomidine on the incidence of AF in patients admitted to the intensive care unit after CABG surgery.
Methods: In this study, 100 patients underwent CABG surgery and randomly divided into two groups of dexmedetomidine and control. In the dexmedetomidine group, the drug was initiated at the time of closing the sternum at a dose of 0.7 μg/ kg /h and continued in the ICU at a dose of 0.5 μg/ kg /hr as an adjuvant and primary analgesic. Then, the effect of dexmedetomidine on atrial fibrillation and the effects of medication on the duration of hospitalization, the cost of hospitalization and stay in ICU, as well as heart rate, blood pressure and pain in patients were investigated first.
Results: The results showed that there was no significant difference in the incidence of AF after CABG surgery between the two experimental and control groups. On the other hand, patients in the dexmedetomidine group were hospitalized less frequently in the hospital than the control group, which led to a reduction in hospital costs. In addition, pulse, systolic blood pressure, and pain and sedation were significantly lower in control group (P<0.05).
Conclusion: Although the use of dexmedetomidine did not result in a difference in the incidence of AF after CABG surgery, the use of this drug reduced hospital stays, pulse rate, blood pressure and pain in patients.

Yusuf S, Reddy S, Ôunpuu S, Anand S. Global burden of cardiovascular diseases. Circulation. 2001; 104(23):2855-64.

Archbold R, Curzen N. Off-pump coronary artery bypass graft surgery: the incidence of postoperative atrial fibrillation. Heart. 2003; 89(10):1134-7.

Brilakis ES, Held C, Meier B, Cools F, Claeys MJ, Cornel JH, et al. Effect of ticagrelor on the outcomes of patients with prior coronary artery bypass graft surgery: insights from the PLATelet inhibition and patient outcomes (PLATO) trial. Am Heart J. 2013; 166(3):474-80.

Creswell LL, Damiano RJ. Postoperative atrial fibrillation: an old problem crying for new solutions. J Thorac Cardiovasc Surg. 2001; 121(4):638-41.

Chugh SS, Blackshear JL, Shen W-K, Hammill SC, Gersh BJ. Epidemiology and natural history of atrial fibrillation: clinical implications. J Am Coll Cardiol. 2001; 37(2):371-8.

Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS, et al. Lifetime risk for development of atrial fibrillation the Framingham heart study. Circulation. 2004; 110(9):1042-6.

Gungor H, Eryilmaz U, Akgullu C, Zencir C, Kurtoglu T, Selvi M, et al. Preoperative poor coronary collateral circulation can predict the development of atrial fibrillation after coronary artery bypass graft surgery. Coron Artery Dis. 2013; 24(7):572-6.

Mithani S, Akbar MS, Johnson DJ, Kuskowski M, Apple KK, Bonawitz-Conlin J, et al. Dose dependent effect of statins on postoperative atrial fibrillation after cardiac surgery among patients treated with beta blockers. J Cardiothorac Surg. 2009; 4:61.

Yang Q, Qi X, Li Y. The preventive effect of atorvastatin on atrial fibrillation: a meta-analysis of randomized controlled trials. BMC Cardiovasc Disord. 2014; 14:99.

McDonald T, Hoffman WE, Berkowitz R, Cunningham F, Cooke B. Heart rate variability and plasma catecholamines in patients during opioid detoxification. J Neurosurg Anesthesiol. 1999;11(3):195-9.

Belleville JP, Ward DS, Bloor BC, Maze M. Effects of intravenous dexmedetomidine in humans: I. Sedation, ventilation, and metabolic rate. Anesthesiology. 1992; 77(6):1125-33.

Triltsch AE, Welte M, von Homeyer P, Groe J, Genähr A, Moshirzadeh M, et al. Bispectral index-guided sedation with dexmedetomidine in intensive care: A prospective, randomized, double blind, placebo-controlled phase II study. Crit Care Med. 2002; 30(5):1007-14.

LeRiger M, Naguib A, Gallantowicz M, Tobias JD. Dexmedetomidine controls junctional ectopic tachycardia during Tetralogy of Fallot repair in an infant. Ann Card Anaesth. 2012; 15(3):224-8.

Tobias J. Dexmedetomidine: applications in pediatric critical care and pediatric anesthesiology. Pediatr Crit Care Med. 2007; 8(2):115-31.

Tobias JD, Gupta P, Naguib A, Yates AR. Dexmedetomidine: applications for the pediatric patient with congenital heart disease. Pediatr Cardiol. 2011; 32(8):1075-87.

Geng J, Qian J, Cheng H, Ji F, Liu H. The Influence of Perioperative Dexmedetomidine on Patients Undergoing Cardiac Surgery: A Meta-Analysis. PLoS One. 2016; 11(4):e0152829.

Turan A, Bashour CA, You J, Kirkova Y, Kurz A, Sessler DI, et al. Dexmedetomidine sedation after cardiac surgery decreases atrial arrhythmias. J Clin Anesth. 2014; 26(8):634-42.

Narisawa A, Nakane M, Kano T, Momose N, Onodera Y, Akimoto R, et al. Dexmedetomidine sedation during the nighttime reduced the incidence of postoperative atrial fibrillation in cardiovascular surgery patients after tracheal extubation. J Intensive Care. 2015; 3(1):26.

Sairaku A, Yoshida Y, Hirayama H, Nakano Y, Ando M, Kihara Y. Procedural sedation with dexmedetomidine during ablation of atrial fibrillation: a randomized controlled trial. Europace. 2014;16(7):994-9.

Abdulkadir A, You J, Saager L, Bashour A, Kurz A, Sessler DI, et al. Effect of Dexmedetomidine on Atrial Arrhythmias after Cardiac Surgery. The Anesthesiology(abstract).

Ai D, Xu G, Feng L, Yu J, Banchs J, Vaporciyan AA, et al. Dexmedetomidine does not reduce atrial fibrillation after lung cancer surgery. J Cardiothorac Vasc Anesth. 2015; 29(2):396-401.

Chrysostomou C, Sanchez-de-Toledo J, Wearden P, Jooste EH, Lichtenstein SE, Callahan PM, et al. Perioperative use of dexmedetomidine is associated with decreased incidence of ventricular and supraventricular tachyarrhythmias after congenital cardiac operations. Ann Thorac Surg. 2011; 92(3):964-72.

Rajput RS, Das S, Makhija N, Airan B. Efficacy of dexmedetomidine for the control of junctional ectopic tachycardia after repair of tetralogy of Fallot. Ann Pediatr Cardiol. 2014; 7(3): 167–172.

IssueVol 4 No 1 (2018): Winter QRcode
SectionResearch Article(s)
dexmedetomidine atrial fibrillation Coronary artery bypass graft surgery

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Azimaraghi O, Atef Yekta R, Movafegh A, Marashi SM, Najafi Abrandabadi A, Naseh E, Saliminia A. The Effect of Dexmedetomidine on the Incidence of Atrial Fibrillation after Coronary Artery Bypass Graft Surgery. Arch Anesth & Crit Care. 2018;4(1):403-408.