By Inflame A clinical trial conducted in China has demonstrated that partial cardiac denervation (pCAD) is an effective method for reducing the risk of atrial fibrillation (AF) following coronary artery bypass grafting (CABG). Published in JAMA Cardiology, the study highlights the potential of this surgical technique in addressing one of the most common complications after cardiac surgery.
Postoperative atrial fibrillation (POAF) is a frequent and challenging issue linked to longer hospital stays, higher medical costs, and increased health risks. While medications and other measures are available, preventing POAF remains a major clinical challenge. To address this, researchers led by Ziang Yang from the Chinese Academy of Medical Sciences explored whether pCAD—removing targeted nerve tissues around the heart—could effectively lower the risk of POAF in CABG patients.
The trial was conducted between August 2022 and December 2023, involving 430 adult patients undergoing isolated CABG. Participants were randomly divided into two groups: one received CABG with pCAD, while the other underwent CABG alone. The study closely monitored patients for six days after surgery to detect episodes of AF lasting over 30 seconds.
The findings were remarkable. The group that underwent pCAD had a significantly lower rate of POAF (18.1%) compared to the control group (31.6%), translating to a 43% reduction in risk. Additional analysis using survival curves confirmed these results, showing a hazard ratio of 0.53. Importantly, the safety assessments revealed no significant differences in complications between the two groups, and the pCAD group also experienced lower postoperative medical costs.
The pCAD procedure involves cutting the ligament of Marshall (LOM) and removing fat tissue along the Waterston groove. According to the researchers, this targeted nerve removal approach effectively minimizes disruptions in the heart’s electrical activity, reducing the likelihood of AF.
“These results show that partial cardiac denervation could be a safe and effective addition to bypass surgery, offering a reliable way to reduce POAF risk without increasing complications,” the study concluded. This innovation could become a valuable tool for cardiac surgeons in improving outcomes for bypass surgery patients.