Is it unnecessary to attach a temporary pacing wire in off-pump coronary artery bypass?

In open heart surgery, the efficacy of temporary pacing to control perioperative cardiac dysrhythmias is well known. However, a temporary pacing wire is not routinely attached during minimally invasive direct coronary artery bypass because of its less invasiveness. In case of off-pump coronary artery bypass (OPCAB) with mediansternotomy, is it also unnecessary? We report 2 patients undergoing OPCAB without postoperative temporary pacing wire who suffered from possibly fatal rhythm disturbances after operation, and needed long hospitalization. After these experiences, we routinely attach a temporary pacing wire during OPCAB with mediansternotomy. We believe, in case of OPCAB, a temporary pacing wire is as effective as in conventional CABG.