A comparative study on the efficacy of ivabradine and beta-blocker combination versus beta-blocker only for the prevention of early post-operative atrial fibrillation after coronary artery bypasses grafting surgery / Shady Charles Boshra Megally ; Supervised Magdy Abdelhamid Abdelaziz , Ahmed Shehata Mohamed , Ahmad Samir Mohamed Abdelhamid

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Cardiology

Post-operative atrial fibrillation is a commonly occurring complication after cardiac surgeries, and carries a significant impact on short- and long-term morbidity and mortality. Multiple strategies and approaches were tested and implemented with the aim of identifying the patients at high risk of developing this arrhythmia, and preventing its occurrence.This work aimed to investigate the value of adding the heart rate controlling drug Ivabradine to Bisoprolol, a well-established beta-blocker in reducing the occurrence of post-operative atrial fibrillation after coronary artery bypass grafting surgery.Two groups of patients scheduled for coronary artery bypass grafting surgery were randomly assigned to either Bisoprolol alone or Bisoprolol plus Ivabradine therapy pre- and post-operatively.They were monitored post-operatively for the occurrence of any arrhythmia especially atrial fibrillation, in addition to undergoing 24-hour Holter ECG analysis 30 days after surgery for the detection of paroxysmal or asymptomatic atrial fibrillation.The combination group in this study did not achieve a significant reduction in the occurrence of post-operative atrial fibrillation, either during hospital stay or in the Holter analysis 30 days after surgery. Advanced age and elevated heart rate post-operatively were identified as predictors for the occurrence of atrial fibrillation in this study

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