Sinus node function after cardiac surgery
| Autor: | Joost M.A.A. van der Maaten, Isabelle C. Van Gelder, Corine P Volkers, Maarten P. van den Berg, Jan G. Grandjean, Rolf C.G. Gallandat Huet, Andries J. Smit, Tjark Ebels, Robert G. Tieleman, Harry J.G.M. Crijns, AE Tuinenburg |
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| Přispěvatelé: | Faculteit Medische Wetenschappen/UMCG, Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Vascular Ageing Programme (VAP) |
| Jazyk: | angličtina |
| Rok vydání: | 2004 |
| Předmět: |
Male
Time Factors PERIOD maze procedure DISEASE Coronary artery bypass surgery Postoperative Complications Heart Rate Mitral valve Atrial Fibrillation Heart rate variability FLUTTER Sinus rhythm Prospective Studies Sinoatrial Node coronary artery bypass surgery Cardiopulmonary Bypass Exercise Tolerance HEART-RATE-VARIABILITY medicine.diagnostic_test Atrial fibrillation PREOPERATIVE ATRIAL-FIBRILLATION III PROCEDURE Middle Aged Atrial Function Cardiac surgery medicine.anatomical_structure Treatment Outcome Anesthesia Cardiology cardiovascular system Female Cardiology and Cardiovascular Medicine Adult medicine.medical_specialty sinus node function Heart Conduction System Internal medicine Heart rate medicine Humans Cardiac Surgical Procedures Aged REPAIR business.industry DELAYED IMPROVEMENT TRANSPLANTATION medicine.disease DYSFUNCTION Electrocardiography Ambulatory Exercise Test murat valve surgery business Electrocardiography Follow-Up Studies |
| Zdroj: | International Journal of Cardiology, 95(1), 101-108. ELSEVIER IRELAND LTD |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2003.05.002 |
| Popis: | Background: Maze surgery is a final solution for intractable atrial fibrillation (AF), but an adverse effect on postoperative sinus node function has been reported. Whether this also applies to other types of cardiac surgery is unclear. Methods: We assessed postoperative rhythm by means of repeated exercise tolerance testing, ambulatory electrocardiography, and non-invasive testing of autonomic function between 1 and 12 months after four types of cardiac surgery. Fourteen patients without structural cardiac disease and medically refractory AF underwent the maze III procedure, 11 patients with mitral valve disease and preoperative AF underwent valvar surgery combined with a (simplified) maze III procedure, and 8 patients with mitral valve disease in sinus rhythm (SR) underwent isolated valvar surgery. The control group consisted of eight patients with sinus rhythm who underwent coronary artery bypass surgery (CABG). Results: One month after surgery, the chronotropic response to exercise was depressed, mean heart rate was high, and heart rate variability (HRV) was low, especially after maze III, combined surgery, and isolated valvar surgery. Twelve months after surgery, moderate improvements were observed. After CABG, considerably fewer abnormalities were observed, and HRV parameters recovered to a large extent. Non-invasive testing of autonomic function indicated disturbed vagal modulation of heart rate in all three groups with atrial incision. Conclusion: Thus, attenuation of HRV and vagal modulation of sinus node function are not confined to maze surgery but also apply to isolated mitral valve surgery. Atrial incision therefore appears to be crucial and presumably produces autonomic nervous damage followed by partial reinnervation. Nevertheless, cardiac surgery in general seems initially to impair sinus node function with partial recovery in the consecutive 12 months. (C) 2003 Elsevier Ireland Ltd. All rights reserved. |
| Databáze: | OpenAIRE |
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