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13.
Comparison of sequential changes in heart rate variability after on-pump and off-pump coronary artery bypass grafting
Kališnik, Jurij-Matija ...
Background: Cardiac vagal modulation is reduced in patients with coronary artery disease or previous myocardial infarction. The propensity to lethal arrhythmias and oxygen consumption is thus ...increased. The objective of the present study was to assess the effect of different techniques used in coronary artery bypass grafting (CABG), namely on-pump versus off-pump, on thelevel of vagal modulation in the immediate postoperative period. Methods: Thirty-three patients, aged 34-76 years were enrolled in the study. Six patients undergone off-pump CABG; the rest were operated on-pump. The electrocardiograms (ECG) and respiratory waveform signals were recorded in theafternoons in supine position. Power spectra of the heart rate variability (HRV) were computed using Fast Fourier Transform analysis (FFT). The followingHRV indexes were calculated: total power (TP) of spectra was defined in the range of 0.01-0.40 Hz, high frequency (HF) power within 0.150.40 Hz, low frequency (LF) power within 0.04-0.15 Hz. Normalized power (n) was definedas the ratio of power in each band / total power. The nHF power indicated cardiac vagal modulation; nLF power indexed sympathetic baroreflex modulated activity. The LF/HF ratio represented sympathovagal balance. Kolmogorov-Smirnov test, paired t-test or Wilcoxon signed rank and Mann-Whitney U test have been applied in statistical analysis, a value of p<0.05 was considered significant. Results: The HRV indexes were diminished markedly after CABG regardless of the technique applied. TP, HF, LF, LF/HF ratio changed by 40 - 70%, the differences were significant on fourth and seventh postoperative day. Comparing off-pump versus on-pump group, the HF power was significantly higher by factor 2 in off-pump patients on the fourth and seventh day after CABG. (Abstract truncated at 2000 characters).
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