Postoperative Conduction Disturbances Requiring Temporary Pacing Following Adult Cardiac Surgery: Frequency, Perioperative Associations, and Early Clinical Outcomes in a Prospective Cohort Study

Abstract

Objective: To determine the frequency and types of postoperative conduction disturbances requiring temporary pacing, identify associated perioperative factors, and evaluate short-term clinical outcomes among adult patients undergoing cardiac surgery. Methodology: This prospective cohort study included a total of 178 consecutive adult patients undergoing coronary artery bypass grafting (CABG), valve surgery, or combined procedures were enrolled. Demographic characteristics, preoperative clinical variables, operative details, postoperative conduction abnormalities, temporary pacing requirements, and in-hospital outcomes were prospectively recorded using standardized data collection forms. Results: Among the 178 patients included, postoperative conduction disturbances occurred in 54 (30.3%). Patients who developed conduction disturbances were significantly older than those without disturbances (64.3 ± 10.2 vs. 55.9 ± 10.8 years, p<0.001) and had higher frequencies of hypertension, diabetes mellitus, and preoperative conduction abnormalities. Longer cardiopulmonary bypass duration (121.3 ± 30.1 vs. 96.2 ± 24.3 minutes, p<0.001), prolonged aortic cross-clamp time (81.7 ± 19.4 vs. 62.4 ± 16.2 minutes, p<0.001), valve surgery, and intraoperative complications were significantly associated with postoperative conduction disturbances. Atrioventricular block was the most frequent conduction abnormality and represented the principal indication for temporary pacing. The mean duration of temporary pacing was 3.6 ± 2.1 days, with recovery of intrinsic rhythm observed in 77.8% of patients, while 18.5% required permanent pacemaker implantation. Patients with conduction disturbances experienced significantly longer ICU and hospital stays than those without conduction abnormalities. Conclusion: Postoperative conduction disturbances requiring temporary pacing are common following adult cardiac surgery and are associated with advanced age, pre-existing conduction abnormalities, prolonged operative duration, and valve surgery.