Arrhythmia in on Pump vs. Off Pump Coronary Artery Bypass Grafting

Study Overview
=================
Brief Summary
-----------------
The aim of this research is to know the incidence of arrhythmias in on vs. off pump CABG and to know their relations to the patient's morbidity and mortality, hospital stay and hospital costs.

Detailed Description
-----------------
On pump vs. off pump CABG has been a topic of debate for many years regarding the benefits and the risks of each technique .Off pump CABG began 30 years ago. Its promotion was based on its potential benefits over some of the limitation of traditional on pump CABG. It avoids the trauma of cardiopulmonary bypass (CPB) and minimizing aortic manipulation and reducing length of hospital stay and morbidity. There is a criticism regarding completence of revascularization in off pump vs. on pump CABG, this is no longer valid in the current era as technology to safely perform multi vessel off pump has improved tremendously over the past decade. One of the debates between these two techniques was the incidence of arrhythmias in and after the operation and its relation to morbidity and mortality at the operation and hospital stay after the operation. As known atrial fibrillation (AF) is still the most common arrhythmia that occur after CABG and although in some studies it has been considered a benign and self-limiting complication, some suggest serious morbidity and mortality from this complication, it is said that it affects more than 40% of patients underwent CABG. Atrial fibrillation (AF) may lead to thromboembolic complications, additional pharmacotherapy, longer hospital stay, increase cost, anxiety and stroke. Most AF post CABG are found in the second to third post-operative day. SO, on this study the investigators focus one the incidence of arrhythmias, especially AF in those two techniques and their relations to patients' morbidity and mortality.

Official Title
-----------------
Arrhythmia in on Pump vs. Off Pump Coronary Artery Bypass Grafting

Conditions
-----------------
Ischemic Heart Disease

Intervention / Treatment
-----------------
* Device: cardio pulmonary bypass machine


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: All patients subjected to CABG Exclusion Criteria: Associated valvular heart disease Emergency cases Previous AF

Ages Eligible for Study
-----------------
Minimum Age: 40 Years
Maximum Age: 80 Years

Sexes Eligible for Study
-----------------
All

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| on pump CABG<br>patients under going CABG with cardiopulmonary bypass machine | Device: cardio pulmonary bypass machine<br>* cardio pulmonary bypass machine is a machine that work to compensate for the function of the heart and the lungs in the operation<br>|
| off pump CABG<br>patients under going CABG without cardiopulmonary bypass machine | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the incidence of arrhythmias in on pump vs. off pump coronary artery bypass grafting | the frequency of arrhythmia s (in number of episodes) using a12-leads continuous electrocardiogram(ECG) in each type of the two operations.the number of patients that experience those arrhythmia s (in percentage) from the total number of patients that go for those two operations. | the number of episodes of arrhythmia s in one week after the operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| decrease morbidity, mortality, hospital stay and hospital cost | To know the relation of the arrythmias in the number of days that the patient stays after the operation. To know the relation of the arrhythmias as a cause to the mortality of these patients.(number of patients die after the operation from the total deaths from these two operations). To know the the relation of the arrhythmias in these two operations to their patients morbidity. | baseline |