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©The Author(s) 2025.
World J Cardiol. Sep 26, 2025; 17(9): 110756
Published online Sep 26, 2025. doi: 10.4330/wjc.v17.i9.110756
Published online Sep 26, 2025. doi: 10.4330/wjc.v17.i9.110756
Table 1 Presents baseline characteristics, operative data, and procedural details of the included studies, mean ± SD/n (%)
| Omran et al[11] | Melo et al[19] | Yang et al[10] | Alex et al[14] | Breda et al[15] | ||||||
| Denervation group | Control group | Denervation group | Control group | Denervation group | Control group | Denervation group | Control group | Denervation group | Control group | |
| Sample size | 110 | 110 | 207 | 219 | 215 | 215 | 70 | 70 | 25 | 25 |
| Year of publication | 2010 | 2004 | 2025 | 2005 | 2008 | |||||
| Type of study | RCT | Case control study | RCT | Prospective cohort study | RCT | |||||
| Country of study | Iran | Portugal, Türkiye, Netherlands | China | United Kingdom | Brazil | |||||
| Procedure | CABG with ventral cardiac denervation | CABG without ventral cardiac denervation | CABG with ventral cardiac denervation | CABG without ventral cardiac denervation | CABG with partial cardiac denervation | CABG without partial cardiac denervation | CABG with ventral cardiac denervation | CABG without ventral cardiac denervation | CABG with ventral cardiac denervation | CABG without ventral cardiac denervation |
| Denervation procedure | Removal of fat pads and surrounding nerve tissues around the great vessels at the heart’s base, starting at the ascending aorta and extending to the pulmonary artery and SVC using electrocautery | Excision of fat pads and nerve tissues around the SVC, aorta, and anterior pulmonary artery, starting from the right pericardial cavity and extending to the left border of the pulmonary artery | Cutting off the LOM and resecting the fat pad along the Waterston groove | Excision of the adventitia and periadventitial fat using scissors and forceps, starting around the superior vena cava, then the ascending aorta, and finally the pulmonary artery, without using cauterization | Removal of nerves and adipose tissue around the great vessels, starting at the SVC and ending at the pulmonary artery | |||||
| Baseline data | ||||||||||
| Age (years) | 63.47 ± 7.80 | 62.18 ± 7 | 60 ± 10 | 62 ± 8 | 61.9 ± 7.9 | 61.9 ± 7.6 | 64.8 ± 9.6 | 65.3 ± 9 | 57.6 ± 13.9 | 59.4 ± 7.57 |
| Male | 89 (80.9) | 88 (80) | 157 (76) | 164 (75) | 176 (81.9) | 175 (81.4) | 58 (83) | 60 (85.7) | 13 (52) | 16 (64) |
| Comorbidities | ||||||||||
| Diabetes mellitus | 34 (30.9) | 29 (26.4) | 54 (26) | 59 (27) | 108 (50.2) | 93 (43.3) | 11 (16) | 9 (13) | 12 (48) | 8 (32) |
| Hypertension | 50 (45.5) | 60 (54.5) | 75 (36) | 87 (40) | 152 (70.7) | 165 (76.7) | 46 (65) | 40 (57) | 22 (88) | 17 (68) |
| COPD | 7 (6.4) | 8 (7.3) | 6(3) | 4 (2) | 3 (1.4) | 1 (0.5) | 7 (10) | 8 (11) | NA | NA |
| Left- main disease | 9 (8.9) | 7 (6.6) | 29 (14) | 35 (16) | 36 (16.7) | 42 (19.5) | NA | NA | 3 (12) | 3 (12) |
| Triple vessel disease | NA | NA | 149 (72) | 145 (66) | 183 (85.1) | 188 (87.4) | 53 (76) | 53 (75) | 16 (64) | 13 (52) |
| Two vessel disease | NA | NA | 29 (14) | 39 (18) | NA | NA | 16 (23) | 15 (22) | 5 (20) | 5 (20) |
| Medication history | ||||||||||
| Beta-blockers | NA | NA | 155 (75) | 177 (81) | 188 (87.4) | 188 (87.4) | 48 (69) | 50 (72) | 23 (92) | 23 (92) |
| Operative data | ||||||||||
| CPB used (on-pump) | 110 (100) | 110 (100) | 170 (82) | 173 (79) | 86 (40) | 91 (42.3) | 70 (100) | 70 (100) | 24 (96) | 22 (88) |
| CPB time (minutes) | 66.62 ± 13.61 | 60.91 ± 16.44 | 95 ± 19 | 99 ± 19 | 101.67 ± 32.09 | 107.33 ± 38.06 | 57.1 ± 13.5 | 54.3 ± 12.2 | NA | NA |
| Cross-clamp time (minutes) | 38.74 ± 8.42 | 36.63 ± 17.35 | NA | NA | 72.17 ± 25.38 | 75.00 ± 28.36 | 34.3 ± 7.5 | 33.4 ± 7.5 | NA | NA |
| Number of grafts | 3.86 ± 0.77 | 3.27 ± 0.77 | 3.2 ± 0.4 | 2.9 ± 0.1 | 3.7 ± 0.8 | 3.8 ± 0.8 | 2.8 (NR) | 2.9 (NR) | 2.92 ± 0.81 | 2.48 ± 0.82 |
| Denervation (minutes) | NA | NA | 5 ± 2 | NA | NA | NA | 5 | NA | 7.64 + 2.33 | NA |
Table 2 Provides an overview of the key findings from the included studies
| Outcomes | Number of studies | Effect model | MD/OR | I2 (%) | P value for heterogeneity | Effect size | P value |
| AF (number) | 5 | RE | OR | 83 | < 0.0001 | 0.71 (0.32-1.58) | 0.40 |
| Postoperative persistent AF | 2 | FE | OR | 0 | 0.97 | 0.19 (0.10-0.36) | < 0.00001 |
| Reoperation for bleeding | 2 | FE | OR | 0 | 0.35 | 0.63 (0.16-2.44) | 0.50 |
| TIA/stroke after cardiac surgery | 2 | FE | OR | 0 | 0.54 | 0.50 (0.09-2.73) | 0.42 |
| Length of hospital stay (days) | 5 | RE | MD | 59 | 0.04 | -0.14 (-0.54 to 0.27) | 0.50 |
| 30-day mortality | 2 | FE | OR | 0 | 0.69 | 0.58 (0.12-2.72) | 0.49 |
| Post-operative blood drainage (mL) | 3 | FE | MD | 0 | 0.72 | 2.22 (-23.60 to 28.03) | 0.87 |
| Post-operative magnesium (mmol/L) | 2 | FE | MD | 0 | 0.67 | -0.07 (-0.08 to -0.06) | < 0.00001 |
- Citation: Bakht D, Amir M, Saleem F, Asif A, Mubashir MM, Farooq AS, Malik MZ, Hassan A, Bakht K, Arham M, Bokhari SFH, Awais MN, Buhadur Ali MK, Dad A, Akram MR. Systematic review and meta-analysis: Is surgical cardiac denervation effective against postoperative atrial fibrillation? World J Cardiol 2025; 17(9): 110756
- URL: https://www.wjgnet.com/1949-8462/full/v17/i9/110756.htm
- DOI: https://dx.doi.org/10.4330/wjc.v17.i9.110756