Document Detail


Prolonged bradyarrhythmias after isolated coronary artery bypass graft surgery.
MedLine Citation:
PMID:  8237749     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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)
Authors:
G Emlein; S K Huang; L A Pires; K Rofino; O N Okike; T J Vander Salm
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  126     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1993-11-29     Completed Date:  1993-11-29     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1084-90     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, University of Massachusetts Medical Center, Worcester 01655.
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MeSH Terms
Descriptor/Qualifier:
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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