The risk of arrhythmias following coronary artery bypass surgery: do smokers have a paradox effect?

Nael Al-Sarraf, Lukman Thalib, Anne Hughes, Maighread Houlihan, Michael Tolan, Vincent Young, Eillish McGovern
2010 Interactive Cardiovascular and Thoracic Surgery  
have a paradox effect? The risk of arrhythmias following coronary artery bypass surgery: do smokers http://icvts.ctsnetjournals.org/cgi/content/full/11/5/550 located on the World Wide Web at: The online version of this article, along with updated information and services, is 1569-9293. (ESCVS). Abstract Smoking is reported to increase the risk of arrhythmias. However, there are limited data on its effects on arrhythmias following coronary artery bypass graft (CABG). This is a retrospective
more » ... w of a prospective database of all CABG patients over an eight-year period. Our cohort (ns2813) was subdivided into: current (ns1169), former (ns837), and non-smokers (ns807). Predictors of arrhythmias following CABG in relation to smoking status were analysed. Atrial arrhythmias occurred in 942 patients (33%). Ventricular arrhythmias occurred in 48 patients (2%) and high-grade atrioventricular block occurred in five patients (0.2%). Arrhythmias were lower in current smokers than former and non-smokers (29% vs. 40% vs. 39%, respectively P-0.001). Logistic regression analysis showed 30% arrhythmia risk reduction in smokers compared to non-smokers wodds ratio (OR) 0.7, 95% confidence intervals (CI) 0.5-0.8x and this effect persisted after accounting for potential confounders while former smokers had the same risk as non-smokers (OR 1.04, CI 0.9-1.3). There were no significant differences in mortality. Smokers are less prone to develop arrhythmias following CABG. This paradox effect is lost in former smokers. This effect is possibly due to a lower state of hyper adrenergic stimulation observed in smokers than non-smokers following the stress of surgery.
doi:10.1510/icvts.2010.242586 pmid:20713536 fatcat:y4eahnadlnbanpz3pjzuqq6wla