الفهرس 
Aim of the WorkOnly 14 pages are availabe for public view
 |  | from | 125 |  |  |
| | | from | 125 | | |
Abstract
The aims of the present study were to evaluate the efficacy of the perioperative use of Bisoprolol and Ivabradine versus Bisoprolol in the prevention of postoperative atrial fibrillation in patients undergoing elective coronary artery bypass grafting (CABG) surgery and to observe whether or not other types of cardiac arrhythmias may arise in the light of giving the previously mentioned drugs perioperatively in elective CABG patients and to observe incidence of side effects as severe bradycardia.
This prospective interventional study included 50 adult patients who underwent elective coronary artery bypass graft surgery. Patients were recruited and assessed for eligibility from Department of Cardiothoracic Surgery in Benha University Hospitals. Patients were randomly divided into two equal groups; group I included patients who received Ivabradine (Procoralan®) and Bisoprolol (concor®) and group II included patients who received Bisoprolol (concor®) only. Both groups received their treatments 48 hours before surgery and continued one week postoperatively.
The present study revealed no statistically significant differences between the studied groups regarding the demographic data including age and gender and the medical history including DM, hypertension, hyperlipidemia, COPD and smoking habit. Regarding the preoperative vital signs, laboratory findings and the echocardiographic data, there were no significant differences between the studied groups.
The present study revealed that aortic clamp time was significantly higher in group I than in group II (P value =0.044), meanwhile, bypass time was insignificantly different between both groups. Moreover, there were no significant differences between the studied groups regarding the angiographic and operative data.
Regarding the postoperative vital signs, the present study revealed a statistically significant decrease in each of HR among patients in group I compared with group II (69.72 ± 7.66 vs. 74.28 ± 7.23 beats/min, respectively) and SBP (126.4 ± 14.49 vs. 135.76 ± 16.52 mmHg, respectively) and DBP (75.32 ± 8.02 vs. 80.68 ± 9.21 mmHg, respectively) (P value<0.05).
Regarding the postoperative echocardiographic data of the studied groups, the present study revealed a statistically significant decrease in LV EF among patients in group I compared with group II (49.44 ± 5.92 vs. 52.8 ± 5.21%, respectively) and a statistically significant increase in each of LV ESD among patients in group II compared with group I (39.32 ± 3.2 vs. 37.32 ± 3.51 mm) and LAVI (34.16 ± 2.53 vs. 32.08 ± 2.9 ml, respectively). Regarding MR grade, there was a statistically significant increase in MR grade 1 (48% vs. 20%) and grade 3 (12% vs. 4%) among patients in group II compared with group I.
In the present study, postoperative prevention of postoperative atrial fibrillation in the combined therapy (Ivabradine plus Bisoprolol) group was more effective than Bisoprolol given alone. Regarding the incidence of postoperative atrial fibrillation of the studied groups, the present study revealed that there was a statistically significant increase in the overall postoperative atrial fibrillation among patients in group II compared with group I (36% vs. 4%, respectively, P value=0.01).
Regarding the ICU and hospital stay in the studied groups, the present study revealed