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Rhythm disturbances after blood and crystalloid cardioplegia in coronary artery bypass grafting

E J Pehkonen1, P M Reinikainen, M J Kataja

  • 1Department of Surgery, Tampere University Hospital, Finland.

Scandinavian Journal of Thoracic and Cardiovascular Surgery
|January 1, 1995
PubMed

Insights

Both blood and crystalloid cardioplegia increased postoperative rhythm disturbances in coronary artery bypass grafting patients. Myocardial ischemia, not the cardioplegia type, was linked to these arrhythmias.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Cardioplegia Research

Background:

  • Coronary artery bypass grafting (CABG) requires myocardial protection.
  • Cardioplegia solutions, including blood and crystalloid types, are used to achieve this.
  • Postoperative arrhythmias are a known complication following cardiac surgery.

Purpose of the Study:

  • To compare the incidence of postoperative rhythm disturbances between blood and crystalloid cardioplegia in CABG patients.
  • To investigate the relationship between myocardial protection parameters and the occurrence of arrhythmias.

Main Methods:

  • Randomized controlled trial involving 100 patients undergoing CABG.
  • Patients received either blood or crystalloid cardioplegia.
  • Holter monitoring was performed preoperatively and postoperatively in 83 patients.

Main Results:

  • Both cardioplegia groups showed a significant increase in postoperative rhythm disturbances.
  • No significant difference in arrhythmia occurrence was observed between blood and crystalloid cardioplegia groups.
  • Arrhythmias were strongly associated with cross-clamp time, myocardial temperature, fibrillation time, CK-MB levels, and perioperative infarction.

Conclusions:

  • The type of cardioplegia (blood vs. crystalloid) did not influence the incidence of immediate postoperative arrhythmias.
  • Myocardial ischemia and inadequate myocardial protection are primary contributors to postoperative rhythm disturbances after CABG.

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