TEmporary Spinal CoRd StiMulatIon to PrevenNt Atrial FibrillaTION AFter Cardiac Surgery

TEmporary Spinal CoRd StiMulatIon to PrevenNt Atrial FibrillaTION AFter Cardiac Surgery (TerminationAF)

To compare of atrial arrhythmia incidence in patients with coronary artery disease and atrial fibrillation history, undergoing either coronary artery bypass grafting plus temporary spinal cord stimulation or coronary artery bypass grafting alone

The study includes 60 patients. Patients are randomized into 2 groups: coronary artery bypass grafting plus b-blocker treatment (according to guidelines; group I) and coronary artery bypass grafting plus b-blocker treatment (according to guidelines) plus temporary spinal cord stimulation (group 2). Temporary spinal cord stimulation is performed for 3 days before surgery and 7 days after coronary artery bypass grafting. Continuous ECG during intensive care unit stay, daily ECG and 24-h Holter monitor recordings at 7, 14, 21, and 30 days after coronary artery bypass grafting, external loop recorder after discharge from intensive care unit until 30 days after coronary artery bypass grafting. Rhythm status and clinical outcome assessment at 12 month follow up

Inclusion Criteria:

• age 18-80 years;
• indications for coronary artery bypass grafting according to guidelines;
• pre-operative history of paroxysmal atrial fibrillation;
• absent of contraindications for spinal cord stimulation;
• signed inform consent.

Exclusion Criteria:

• previous heart surgery or atrial fibrillation ablation procedure;
• emergency coronary artery bypass grafting;
• left ventricle ejection fraction <35%;
• unstable angina or heart failure;
• persistent atrial fibrillation or atrial fibrillation at the time of screening;
• planned Maze procedure or pulmonary vein isolation;
• use of class I or III antiarrhythmic drugs within 5 elimination half-lives of the drug;
• need for concomitant valve surgery;
• Inability to control the device for spinal cord stimulation;
• coagulopathy, immunosuppression, or other condition associated with an unacceptable surgical risk for spinal cord stimulation;
• Need for therapeutic diathermy in the area of leads placement;
• Need for pacemaker/ICD/CRT-D implantation;
• unwillingness to participate.