Document Detail


Ischemic preconditioning suppresses ventricular tachyarrhythmias after myocardial revascularization.
MedLine Citation:
PMID:  12473557     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Ventricular fibrillation (VF) and tachycardia (VT) are the common and potential life-threatening complications after CABG. Ischemic preconditioning (IP) has been proved effective in reducing ischemia reperfusion arrhythmia in animals and humans. Whether IP is effective in suppressing postoperative VF/VT in patients with CABG has not been studied. METHODS AND RESULTS: Eighty-six patients with CABG with stable and unstable 3-vessel disease were equally randomly assigned into an IP and a control group. The patients who received IP received 2 periods of 2-minute ischemia followed by 3-minute reperfusion. Twenty-four-hour electrocardiographic data were collected. IP resulted in fewer cases of VF after declamping (48.8% versus 79.1% in IP and control, P=0.004) and a shorter VF period (2.28+/-0.44 versus 4.41+/-0.51 minutes, P=0.002). The episodes of VT were significantly reduced in patients in the IP group during early reperfusion and 24 hours after reperfusion (0.65+/-0.16 versus 3.71+/-0.46, P=0.000 and 0.07+/-0.04 versus 2.12+/-1.41, P=0.002, respectively). De novo sustained VT occurred in 3 control patients as against none in the IP group after surgery. As a result, IP significantly curtailed the mechanical ventilation period and reduced the need for inotropes. CONCLUSIONS: IP significantly reduced postoperative VF/VT in patients with CABG with 3-vessel disease. Suppression of VT during early reperfusion and 24 hours after reperfusion suggests early and delayed IP phenomena in patients undergoing CABG surgery.
Authors:
Zhong-Kai Wu; Tiina Iivainen; Erkki Pehkonen; Jari Laurikka; Matti R Tarkka
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  106     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-10     Completed Date:  2002-12-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3091-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiac Surgery, Department of Surgery, Tampere University Hospital, Tampere, Finland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Artery Bypass* / adverse effects
Coronary Artery Disease / surgery
Electrocardiography, Ambulatory
Female
Heart Rate
Humans
Ischemic Preconditioning, Myocardial*
Male
Middle Aged
Myocardial Revascularization* / adverse effects
Tachycardia, Ventricular / etiology,  prevention & control*
Treatment Outcome
Ventricular Fibrillation / etiology,  prevention & control*
Comments/Corrections
Comment In:
Circulation. 2002 Dec 10;106(24):2999-3001   [PMID:  12473541 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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