Avtor/Urednik		Kališnik, Jurij M; Avbelj, Viktor; Trobec, Roman; Ivaskovic, Daroslav; Vidmar, Gaj; Troise, Giovanni; Geršak, Borut
Naslov		Effects of beating- versus arrested-heart revascularization on cardiac autonomic regulation and arrhythmias
Tip		članek
Vir		Heart Surg Forum
Vol. in št.		Letnik 10, št. 4
Leto izdaje		2007
Obseg		str. E279-87
Jezik		eng
Abstrakt		Background: Altered autonomic regulation after cardiac operations precipitates cardiac arrhythmias, affects repolarization, and increases the risk of sudden cardiac death. We sought to clarify how the 2 different techniques of coronary artery bypass grafting (CABG), namely conventional CABG using cardiopulmonary bypass (on-pump) and beating-heart CABG without cardiopulmonary bypass (off-pump), affect cardiac autonomic regulation and arrhythmic disturbances postoperatively. Methods: We included 57 consecutive patients, 28 in the on-pump group and 29 in the off-pump group. The electro-cardiographic recordings were performed on the preoperative day and the fourth, seventh, and twenty-eighth day after operation. Fifteen-minute digital recordings were taken; one channel was used to record electrocardiogram and the other breathing. Detailed analyses of arrhythmia, heart rate, and heart rate variability indices were performed on respective days to assess sympathetic and parasympathetic modulation of the heart and relate it to detected arrhythmic disturbances. Results: Total power, low-frequency power, which indicates baroreceptor-mediated sympathetic modulation, and high-frequency power, indicating parasympathetic vagal modulation, declined significantly in both groups after CABG (P < .001); however, 7 days after CABG, total and high-frequency power were better preserved in the off-pump group. Mean RR interval was longer in the off-pump group at 7 (P= .006) and 28 days (P= .008) after surgery. The total incidence of arrhythmic events was higher in the on-pump group on the seventh day (P = .017, adjusted odds ratio = 8.6, 95% confidence interval 1.4-80.3). Conclusions: The results show profound impairment of cardiac autonomic regulation after CABG, showing better preserved cardiac autonomic modulation 7 days after beating-heart revascularization. (Abstract truncated at 2000 characters)
Deskriptorji		CORONARY ARTERY BYPASS CARDIOPULMONARY BYPASS HEART ARREST, INDUCED ELECTROCARDIOGRAPHY ARRHYTHMIA HEART RATE PULSE AUTONOMIC NERVOUS SYSTEM