Intraoperative Ventricular Arrhythmia During Off-Pump Coronary Artery Bypass grafting-Incidence, Risk Factors, and Outcomes.

Background: Ventricular arrhythmia (VA) is a critical complication of off-pump coronary artery bypass grafting (OPCABG). However, few studies have explored the impact of VA during operative. This study aimed to determine the incidence, risk factors, and outcomes of intraoperative VA.

Methods: This retrospective cohort study consecutively reviewed patients who underwent isolated OPCABG at the Affiliated Hospital of Qingdao University from January 2016 to January 2021. Based on the occurrence of intraoperative VA, patients were divided into an intraoperative VA group and a non-intraoperative VA group. Multivariate logistic and COX regression models were used to determine the independent risk factors of intraoperative VA and the effect on short-term mortality of intraoperative VA, respectively.

Results: A total of 2.4% (44/1829) of the patients experienced intraoperative VA, of whom 43 patients were treated with internal shocks. 22 (50%) patients experienced intraoperative VA during anastomosis. Multivariate logistic regression showed that emergency surgery, heart failure, history of coronary stent implantation, and BMI < 25 kg/m were independent risk factors of intraoperative VA. Among these factors, emergency surgery was the most important predictive factor. The mortality of the intraoperative VA group was much higher than the control group (18.2% vs. 3.6%, adjusted HR = 4.605, 95%CI 2.126-9.978, and P < 0.001).

Conclusion: Emergency surgery, heart failure, history of coronary artery stent implantation, and BMI < 25 kg/m were independent risk factors of intraoperative VA. Intraoperative VA has a low incidence during OPCABG; however, it significantly increases the risk of short-term mortality.