The Effect of Myocardial Surgical Revascularization on Left Ventricular Late Potentials
| Autor: | Hakan Kültürsay, Harun Evrengul, Levent Can, Halil Halil, Kamil Kumanlioglu, Cuneyt Turkoglu, Meral Kayıkçıoğlu |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Ischemia Action Potentials Hemodynamics Coronary Disease Revascularization Scintigraphy Article Ventricular Function Left Electrocardiography Predictive Value of Tests Risk Factors Physiology (medical) Internal medicine medicine Humans Prospective Studies cardiovascular diseases Derivation Coronary Artery Bypass Aged Tomography Emission-Computed Single-Photon Analysis of Variance medicine.diagnostic_test business.industry Signal Processing Computer-Assisted General Medicine Middle Aged medicine.disease Signal-averaged electrocardiogram Thallium Radioisotopes Treatment Outcome Anesthesia Cardiology Female Cardiology and Cardiovascular Medicine business Perfusion |
| Zdroj: | Annals of Noninvasive Electrocardiology. 6:84-91 |
| ISSN: | 1542-474X 1082-720X |
| DOI: | 10.1111/j.1542-474x.2001.tb00091.x |
| Popis: | Background: The presence of ventricular late potentials (LP) is an important indicator for the development of ventricular tachyarrhythmias due to ischemic heart disease. The effect of myocardial revascularization on LP has remained controversial. The purpose of this study was to determine whether complete myocardial surgical revascularization (CABG) documented by myocardial perfusion scintigraphy might alter the substrate responsible for LP. Methods: Prospectively, enrolled patients undergoing elective CABG were evaluated with thallium-201 myocardial perfusion scintigraphy and signal- averaged ECG pre- and postoperatively. SAECG recordings were obtained serially: before, 48–72 hours and 3 months after CABG. LPS were defined as positive if SAECG met at least two of Gomes criteria. Scintigraphies were performed pre-and 3 months postoperatively for determination of the success of revascularization. Changes observed in SAECG recordings after CABG were compared between those with and without successful revascularization. Results: CABG resulted in successful revascularization in 23 patients and was unsuccessful in 17 (no change or deterioration of the perfusion defects). Preoperative SAECG values were not different between groups except for RMS values. The incidence of LP decreased significantly postoperatively in patients with improved myocardial perfusion, whereas there were no changes in patients who did not have postoperative perfusion improvement (McNemar test, P < 0.05). Conclusions: LPs disappear following the elimination of myocardial ischemia by complete surgical revascularization. Persistence of ischemia following CABG usually results in the persistence of late potentials. The incidence of ventricular arrhythmias is expected to be unchanged in these patients and they should be reevaluated for reinterventions. A.N.E. 2001;6(2):84–91 |
| Databáze: | OpenAIRE |
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