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Relation between QRS changes and left ventricular function after coronary artery bypass grafting.

R D Floyd, G S Wagner, E H Austin

    The American Journal of Cardiology
    |November 1, 1983
    PubMed
    Summary

    Electrocardiogram (ECG) QRS changes after coronary artery bypass grafting (CABG) do not reliably indicate changes in left ventricular (LV) function. Exercise ejection fraction improved in patients with minor ECG changes but not those with major QRS alterations post-CABG.

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    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Diagnostic Electrocardiography

    Background:

    • Coronary artery bypass grafting (CABG) is a common surgical intervention for coronary artery disease.
    • Electrocardiograms (ECGs) are frequently used to assess cardiac health before and after CABG.
    • The relationship between ECG changes and left ventricular (LV) function post-CABG requires further clarification.

    Purpose of the Study:

    • To investigate the correlation between preoperative and postoperative electrocardiogram (ECG) findings and left ventricular (LV) function after coronary artery bypass grafting (CABG).
    • To determine if specific QRS complex changes on ECG after CABG reflect alterations in resting and exercise ejection fraction.

    Main Methods:

    • Review of preoperative and serial postoperative electrocardiograms (ECGs) in 104 patients undergoing CABG.

    Related Experiment Videos

  • Classification of patients into five groups based on ECG findings before and after CABG, including QRS changes and prior myocardial infarction.
  • Assessment of resting and exercise radionuclide angiocardiography to evaluate left ventricular (LV) ejection fraction at 1 to 12 months post-CABG.

    • Main Results:

    • Mean resting ejection fraction showed minimal changes across all groups, with a significant increase only in Group I (normal ECG pre- and post-CABG).
    • Group IV (major QRS change post-CABG) exhibited the largest decrease in resting ejection fraction, though not statistically significant.
    • Mean exercise ejection fraction significantly increased in Groups I, II, and III (minor QRS change), but not in Groups IV and V (major QRS change/conduction disturbance).

    Conclusions:

    • Electrocardiogram (ECG) QRS changes after coronary artery bypass grafting (CABG) do not consistently correlate with impairments in left ventricular (LV) function.
    • Patients with minor QRS changes on ECG post-CABG may still experience improved exercise ejection fraction.
    • Further research is needed to understand the prognostic implications of different ECG patterns following CABG.