Early ventricular tachyarrhythmias after coronary artery bypass grafting surgery: Is it a real burden?
Elisabeth M J P Mouws1, Ameeta Yaksh2, Paul Knops2
1Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands; Department of Cardio-thoracic Surgery, Erasmus MC, Rotterdam, The Netherlands.
Insights
Ventricular dysrhythmias (VD) are common after coronary artery bypass grafting (CABG), but sustained arrhythmias like ventricular tachycardia (VT) or ventricular fibrillation (VF) did not occur. Risk factors for VD include male gender and older age.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- The prevalence and characteristics of ventricular dysrhythmias (VD) post-coronary artery bypass grafting (CABG) remain unexamined.
- Understanding VD is crucial as they may precede ventricular tachyarrhythmias (VTA).
Purpose of the Study:
- To investigate the characteristics of VD (ventricular premature beats, couplets, runs) after CABG.
- To determine if VD precede VTA during the early postoperative period.
- To identify predictive factors for VD/VTA.
Main Methods:
- Continuous rhythm monitoring was used in 105 patients undergoing primary, on-pump CABG.
- Incidences and burdens of VD/VTA were calculated.
- Multivariate analysis identified independent risk factors.
Main Results:
- Ventricular premature beats (VPBs), couplets, and runs occurred in 100%, 82.9%, and 48.6% of patients, respectively.
- No sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) were observed.
- Independent risk factors for VD included male gender, mitral valve insufficiency, hyperlipidemia, and age ≥60 years.
Conclusions:
- Ventricular dysrhythmias are frequent following CABG but typically have low burdens.
- Sustained VT or VF did not occur in this patient cohort.
- VD incidence peaked on postoperative day 1 and decreased over time.
Background:
The prevalence of ventricular dysrhythmias (VD) [ventricular premature beats (VPBs), ventricular couplets (Vcouplets), ventricular runs (Vruns)] after coronary artery bypass grafting (CABG) has so far not been examined. The goal of this study is to examine characteristics of VD and whether they precede ventricular tachyarrhythmias (VTA) during a postoperative follow-up period of 5 days using continuous rhythm registrations. In addition, we determined predictive factors of VD/VTA.
Methods:
Incidences and burdens of VD/VTA were calculated in patients (N=105, 83 male, 65±9 years) undergoing primary, on-pump CABG. Independent risk factors were examined using multivariate analysis.
Results:
VPBs, Vcouplets, and Vruns occurred in respectively 100%, 82.9%, and 48.6% with corresponding burdens of 0.05%, 0%, and 0%. Sustained ventricular tachycardia (VT) and ventricular fibrillation (VF) did not occur in our cohort. Independent risk factors for VD included male gender, mitral valve insufficiency, hyperlipidemia, and age ≥60 years.
Conclusions:
VD are common in patients with coronary artery disease after CABG. Despite high incidences of these dysrhythmias, corresponding burdens are low and sustained VT or VF did not occur. Incidences were highest on the first postoperative day and diminished over time.
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