Early ventricular tachyarrhythmias after coronary artery bypass grafting surgery: Is it a real burden?

J Cardiol. 2017 Sep;70(3):263-270. doi: 10.1016/j.jjcc.2016.12.001. Epub 2017 Jan 6.

Abstract

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.

Keywords: Bypass surgery; Continuous rhythm registration; Coronary disease; Electrocardiogram; Ventricular arrhythmia.

MeSH terms

  • Aged
  • Cohort Studies
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / surgery*
  • Female
  • Humans
  • Hyperlipidemias / epidemiology
  • Hyperlipidemias / surgery
  • Incidence
  • Male
  • Middle Aged
  • Mitral Valve Insufficiency / epidemiology
  • Mitral Valve Insufficiency / surgery
  • Risk Factors
  • Tachycardia, Ventricular / epidemiology
  • Tachycardia, Ventricular / etiology*
  • Ventricular Fibrillation / epidemiology
  • Ventricular Fibrillation / etiology*
  • Ventricular Premature Complexes / epidemiology
  • Ventricular Premature Complexes / etiology*