| Prolonged bradyarrhythmias after isolated coronary artery bypass graft surgery. | |
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MedLine Citation:
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PMID: 8237749 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To evaluate clinical and electrocardiographic (ECG) characteristics that may predict the occurrence of bradyarrhythmias after isolated coronary artery bypass graft (CABG) surgery, 1614 consecutive patients who had this procedure performed at our institution from January 1988 to December 1990 were reviewed. Thirteen (0.8%, 7 males and 6 females) patients had prolonged (mean 10.5 +/- 6.5 days) postoperative bradyarrhythmias and required insertion of a permanent pacemaker. Complete heart block occurred in eight patients and sinus node dysfunction in five. These 13 patients (group A) were compared with a group of 490 arbitrarily selected CABG patients (group B) without bradyarrhythmias whose preoperative ECGs were reviewed. Patients in group A were older (mean 69.2 vs 62.8 years; p = 0.0004) and had concomitant left ventricular (LV) aneurysmectomy more frequently (p = 0.02) and internal mammary graft revascularization less frequently (p = 0.022) than group B patients. Review of preoperative ECGs revealed a higher occurrence of complete left bundle branch block (LBBB) (5 of 13 vs 6 of 490; p < 0.0001) and a borderline, more leftward frontal plane QRS axis (-5.3 vs 13.1 degrees, p = 0.068) in group A patients. There were no differences between the groups with respect to gender, number of bypass grafts, location of prior myocardial infarction, and preoperative ECG intervals (PR, QRS, QTc). Multivariate analysis identified the presence of a preoperative LBBB, concomitant LV aneurysmectomy and age > 64 years as independent predictors of severe and prolonged postoperative bradyarrhythmias, mainly complete heart block.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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G Emlein; S K Huang; L A Pires; K Rofino; O N Okike; T J Vander Salm |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American heart journal Volume: 126 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1993 Nov |
Date Detail:
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Created Date: 1993-11-29 Completed Date: 1993-11-29 Revised Date: 2006-02-27 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1084-90 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, University of Massachusetts Medical Center, Worcester 01655. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Aged Aged, 80 and over Bradycardia / etiology Case-Control Studies Coronary Artery Bypass* Coronary Disease / complications, surgery* Female Follow-Up Studies Heart Aneurysm / complications, surgery Heart Block / complications, etiology* Humans Logistic Models Male Middle Aged Postoperative Complications / etiology* Risk Factors Sick Sinus Syndrome / etiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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