Changing incidence of atrial fibrillation following coronary artery bypass grafting: a retrospective analysis.

The cases of 455 consecutive patients undergoing coronary artery bypass grafting (CABG) in one unit between 1990 and 1993 were retrospectively analysed with particular reference to the incidence of atrial fibrillation (AF), and with reference to any postoperative management that might have influenced this incidence. The recorded incidence of AF fell from 21% in 1990 to 11% in 1993. During this same period: the use of potassium chloride (KCl 20-40mmol/l) supplements in the intravenous fluid replacement during the immediate postoperative period increased from 0-96%; the use of intravenous frusemide decreased from 12-3%; and the practice of prescribing up to four Frumil (frusemide/amiloride hydrochloride) tablets daily was replaced by a more usual one tablet daily. Although the aetiology of AF post cardiac surgery is multifactorial, these three factors are implicated in the decreasing incidence of this complication in one unit.