Heart Rate Variability and Coronary Artery Bypass Grafting: A Systematic Review
Patrycja S Matusik1, Omar Alomar2, Maryam Rafaqat Hussain3
1Chair of Radiology, Jagiellonian University Medical College and University Hospital, 30-688 Kraków, Poland.
Insights
Heart rate variability (HRV) changes after coronary artery bypass grafting (CABG) but typically recovers within six months. While traditional HRV measures don't predict post-CABG complications, altered non-linear HRV may indicate higher risk.
Area of Science:
- Cardiology
- Autonomic Nervous System Function
- Surgical Outcomes
Background:
- Coronary artery bypass grafting (CABG) is a key treatment for coronary artery disease.
- Post-CABG patients face risks of cardiovascular events, including arrhythmias.
- Abnormal heart rate variability (HRV) is linked to autonomic dysfunction and arrhythmias after CABG.
Purpose of the Study:
- To systematically review research on heart rate variability (HRV) following coronary artery bypass grafting (CABG).
- To explore the relationship between HRV, autonomic function, and post-CABG complications.
Main Methods:
- Systematic literature search of PubMed, Cochrane, and Embase databases.
- Analysis of relevant English-language articles.
- Focus on time and frequency domain HRV, and non-linear measures.
Main Results:
- HRV acutely decreases post-CABG but recovers by 6 months.
- Pre-existing conditions (heart failure, diabetes, depression) negatively impact post-CABG HRV.
- Cardiac rehabilitation may improve HRV recovery and exercise capacity.
Conclusions:
- Traditional HRV parameters do not reliably predict post-CABG complications.
- Non-linear HRV measures show potential for identifying high-risk patients, including those prone to atrial fibrillation.
- Current data do not confirm early HRV assessment predicts long-term mortality post-CABG.
Background:
Coronary artery bypass grafting (CABG) is a well-established surgical procedure used to treat significant coronary artery disease. Nevertheless, unfavorable cardiovascular events and complications, including cardiac arrhythmias may be observed in patients after CABG. Previous studies have revealed a relationship between risk of cardiac arrhythmias and abnormal heart rate variability (HRV), which reflects adverse alterations in cardiac autonomic functioning, that may occur in patients after a CABG procedure. The aim of this article was to provide a systematic review of the major research findings in this area.
Methods:
A literature search was carried out using PubMed, Cochrane, and Embase databases and relevant articles, published in English, were analyzed in detail.
Results:
Studies performed so far have shown time depending changes in HRV after CABG. Time and frequency domain HRV decrease acutely after CABG but recover almost completely to pre-operative values by 6 months after surgery. Some preoperative clinical states such as: heart failure, type 2 diabetes mellitus and depression adversely affect post-CABG HRV. Finally, post-CABG cardiac rehabilitation appears to improve exercise capacity and speed up recovery of HRV.
Conclusions:
Generally, traditional time and frequency domain HRV parameters fail to predict complications post-CABG. Altered non-linear measures of HRV may identify subgroups of subjects at increased risk of potential complications, including atrial fibrillation post-CABG. However, data available currently does not appear to unequivocally support the hypothesis that early HRV assessment in post-CABG patients predicts long-term mortality.
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