Perioperative myocardial ischemia is associated with a prolonged cardiac vagal dysfunction after non-cardiac surgery

Acta Anaesthesiologica Scandinavica
M DworschakK van Ackern

Abstract

Heart rate variability (HRV), a measure of cardiac autonomic balance seems to be linked to coronary artery disease (CAD). Impaired vagal input facilitates the generation of fatal arrhythmias and has a great impact on morbidity and mortality. The purpose of this study was to determine the relationship between perioperative HRV and the incidence of silent myocardial ischemia (SMI) and ventricular dysrhythmias in CAD-patients undergoing non-cardiac surgery. 31 patients were studied by continuous Holter electrocardiography preoperatively and again on the evening before surgery until postoperative day 3. Three frequency and one time domain measures of HRV (TP, 0.01-1.00 Hz: total power of the amplitude spectral plot; LF, 0.04-0.15 Hz: low-frequency power; HF, 0.15-0.40 Hz: high-frequency power; MeanRR: mean of all coupling RR-intervals between normal beats) as well as ischemic events and ventricular couplets and runs were computed. Depending on the presence of ischemic episodes, each patient was assigned to either the no SMI-group (13 pts) or the SMI-group (18 pts). MeanRR, TP and LF significantly declined in both groups over time. The parasympathetically dominated index HF, however, only decreased in the SMI-group. Normalized HF po...Continue Reading

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Citations

Dec 21, 2006·World Journal of Surgery·Ismail GögenurJacob Rosenberg
Nov 14, 2003·Canadian Journal of Physiology and Pharmacology·C Ann BrownJoel Parlow
Jun 1, 2001·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Joel Parlow

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