Document Detail


Arrhythmias in off-pump coronary artery bypass grafting and the antiarrhythmic effect of regional ischemic preconditioning.
MedLine Citation:
PMID:  12968233     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The authors sought to establish whether regional ischemic preconditioning (IP) reduces ischemic reperfusion arrhythmias in patients who undergo off-pump coronary artery bypass grafting (OPCAB). DESIGN: A controlled, randomized, prospective study. SETTING: A university hospital. PARTICIPANTS: Thirty-two patients with left anterior descending coronary artery (LAD) or 2-vessel heart disease (including LAD) who were to undergo OPCAB were randomized into an IP and a control group. INTERVENTIONS: IP was induced by occluding the LAD twice for a 2-minute period followed by 3-minute LAD reperfusion before bypass grafting of the first coronary vessel. MEASUREMENTS AND MAIN RESULTS: Twenty-four-hour electrocardiography was recorded from the preoperative day to the second postoperative day. The heart rate (HR) was significantly elevated after surgery. Supraventricular extrasystole (SVES) events were similar before and after surgery. The incidence of patients with ventricular extrasystole (VES), supraventricular tachycardia (SVT), atrial fibrillation (AF), and ventricular tachycardia (VT) was significantly increased after the operation. Ventricular arrhythmias occurred mostly during anastomosis and the early reperfusion period and recovered 2 hours after reperfusion. Supraventricular tachyarrhythmias were mostly encountered 24 hours after reperfusion. IP significantly suppressed HR elevation, SVT, and VT after surgery. SVES, VES, and AF episodes were similar between the groups. CONCLUSIONS: Arrhythmia was a common phenomenon during and after an OPCAB procedure. The present IP protocol significantly suppressed HR elevation, the episodes of SVT, and the incidence of VT after surgery.
Authors:
Zhong-Kai Wu; Tiina Iivainen; Erkki Pehkonen; Jari Laurikka; Matti R Tarkka
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  17     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-09-11     Completed Date:  2004-01-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  459-64     Citation Subset:  IM    
Affiliation:
Department of Surgery, Tampere University Hospital, Tampere, Finland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anastomosis, Surgical
Arrhythmias, Cardiac / etiology*,  metabolism,  physiopathology
Atrial Fibrillation / etiology,  metabolism,  physiopathology
Biological Markers / blood
Cardiopulmonary Bypass
Circadian Rhythm / physiology
Coronary Artery Bypass*
Coronary Vessels / surgery
Creatine Kinase / metabolism
Creatine Kinase, MB Form
Electrocardiography
Female
Finland / epidemiology
Heart Rate / physiology
Humans
Incidence
Ischemic Preconditioning, Myocardial / adverse effects*
Isoenzymes / metabolism
Male
Middle Aged
Myocardial Ischemia / metabolism,  physiopathology,  therapy
Prospective Studies
Recurrence
Statistics as Topic
Tachycardia, Supraventricular / etiology,  metabolism,  physiopathology
Tachycardia, Ventricular / etiology,  metabolism,  physiopathology
Time Factors
Treatment Failure
Ventricular Premature Complexes / etiology,  metabolism,  physiopathology
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Isoenzymes; EC 2.7.3.2/Creatine Kinase; EC 2.7.3.2/Creatine Kinase, MB Form

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