Partial cardiac denervation may reduce the incidence of postoperative atrial fibrillation by 47% in patients undergoing coronary artery bypass grafting, according to a recent trial.

In the randomized clinical trial, published in JAMA Cardiology, investigators examined the effect of partial cardiac denervation on the incidence of postoperative atrial fibrillation (AF) in patients undergoing coronary artery bypass grafting (CABG). The trial enrolled 430 participants to determine whether partial cardiac denervation could reduce postoperative AF following CABG.

Patients were randomly assigned to either CABG alone or CABG with partial cardiac denervation, which involved cutting the ligament of Marshall and resecting the fat pad along the Waterston groove. The primary outcome, the incidence of postoperative AF within 6 days after surgery, was significantly lower in the intervention group (18.1%) compared with the control group (31.6%, risk ratio = 0.57, 95% confidence interval [CI] = 0.41–0.81], P = .001). Sensitivity analysis confirmed these results with a hazard ratio of 0.53 (95% CI = 0.36–0.79, P = .002).

No statistically significant differences in complications, such as blood transfusion, reoperation for bleeding, or delayed pericardial effusion, were observed between the groups. Additionally, the intervention group had shorter intensive care unit stays and reduced postoperative medical costs, with a median saving of $143.7 compared with the control group.

These results suggested that partial cardiac denervation could be an effective approach to reduce the occurrence of postoperative AF after CABG, without increasing postoperative complications. Long-term follow-up is needed to further assess the safety and durability of this procedure.

Full disclosures can be found in the published trial.