Characteristics and some factors affecting perioperative ventricular arrhythmias in patients undergoing coronary artery bypass graft surgery

Abstract

Introduction and objectives: Ventricular tachyarrhythmia perioperative coronary artery bypass graft is common and the occurrence has been described, but the incidence and risk factors are not well defined. However, little is known about incidence, risk factors, and treatment of early postoperative arrhythmias. Aim: To evaluate the incidence of arrhythmias and to detect high-risk populations.

Methods: Cross sectional description. The study involved 171 consecutive patients scheduled for elective coronary surgery at Hanoi Heart Hospital from 6/2016 – 8/2018.

Main results:Mean age 65,05 ± 7,41 years; 78,4% male.The number and percentage of preoperative ventricular extrasystoles in patients with myocardial infarction (n=52) was higher than in patients with stable coronary artery disease (n=119) with p<0.05.Severe ventricular arrhythmias (Lown ≥ 3) were higher in patients with myocardial infarction 7 days before and after surgery than in stable coronary artery disease at the same time (p<0.05).Patients with stable coronary artery disease have characteristics of increased ventricular extrasystoles 7 days after surgery, patients with myocardial infarction have no change in ventricular arrhythmias before and 7 days after surgery.The cut-off point of the proBNP test value ≥1000 pg/ml showed a significantly increased number and incidence of severe ventricular arrhythmias both before and 7 days after surgery in both stable coronary artery disease and myocardial infarction.With the same risk factors, if the patient has proBNP ≥1000 pg/ml, the severity of ventricular extrasystoles (Lown ≥ 3) increases 3.04 times (p = 0.05).At 7 days postoperatively, for the same risk factors, women, EF <50% and proBNP ≥1000 pg/ml were independent factors that increased the occurrence of severe ventricular extrasystoles(Lown ≥ 3) increased from 2.9 to 3.4 times p<0.05.

Conclusions: Patients with myocardial infarction had characteristics of ventricular arrhythmias perioperative more than with stable coronary artery disease patients. ProBNP ≥ 1000pg/ml had a risk factor for the development of severe ventricular arrhythmias both before and after coronary artery bypass graft surgery.