Alterations in Temporal Patterns of Heart Rate Variability after Coronary Artery Bypass Graft Surgery

Hogue, Charles W.; Stein, Phyllis K.; Apostolidou, Ioanna; Lappas, Demetrios G.; Kleiger, Robert E.

doi:10.1097/00000542-199412000-00009

Cited by 71 publications

(41 citation statements)

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“…1,3,4,30 We have previously shown that preoperative ␤-blocker use does not influence HRV results after uncomplicated CABG. 27 In the present study, compared with the patients later developing AF, significantly more control patients were receiving ␤-blockers before surgery. However, adjusting for preoperative ␤-blocker use in the multivariate model did not influence our results, suggesting minimal effects of these drugs on our results.…”

Section: Study Limitations and Clinical Implicationsmentioning

confidence: 50%

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RR Interval Dynamics Before Atrial Fibrillation in Patients After Coronary Artery Bypass Graft Surgery

et al. 1998

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Background-Atrial fibrillation/flutter (AF) is a frequent complication of coronary artery bypass graft surgery (CABG) that leads to increased costs and morbidity. We hypothesized that heart rate variability (HRV), an indicator of cardiac sympathovagal balance, is altered before the onset of postoperative AF. Because nonlinear methods of HRV analysis provide information about heart rate dynamics not evident from usual HRV measures, we also hypothesized that approximate entropy (ApEn), a nonlinear measure of HRV, might have predictive value. Methods and Results-Analysis of HRV was performed in 3 sequential 20-minute intervals preceding the onset of postoperative AF (24 episodes in 18 patients). These data were compared with corresponding intervals in 18 sex-and age-matched postoperative control subjects who did not develop AF. Patients had left ventricular ejection fractions Ͼ45% before surgery and were not receiving ␤-blockers during ambulatory ECG monitoring after surgery. Logistic regression demonstrated that on the basis of averaged values for the three 20-minute intervals, increased heart rate and decreased ApEn were independently associated with AF. Heart rate dynamics before AF was associated with either lower (nϭ19) or higher (nϭ5) RR interval variation by traditional measures of HRV or quantitative Poincaré analysis, suggesting the possibility of divergent autonomic conditions before AF onset. Conclusions-In the hour before AF after CABG surgery, higher heart rate and lower heart rate complexity compared with values in control patients were independent predictors of AF. Decreased ApEn occurs in patients with either increased or decreased HRV by traditional measures and may provide a useful tool for risk stratification or investigation of mechanisms. (Circulation. 1998;98:429-434.)

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Section: Study Limitations and Clinical Implicationsmentioning

confidence: 50%

“…27 All procedures used in this study were approved by the Washington University School of Medicine Human Studies Committee, and individual informed consent was obtained. Patients were monitored with Marquette 8500 Holter recorders (leads CC5 and II, Marquette Electronics) for 2 to 3 days after surgery.…”

Section: Methodsmentioning

confidence: 99%

RR Interval Dynamics Before Atrial Fibrillation in Patients After Coronary Artery Bypass Graft Surgery

et al. 1998

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“…Reading recent texts on cardiac valve surgery operation techniques [13][14][15][16] and speaking with experienced cardiac surgeons about possible reasons for the obtained differences in the results of this study between groups of patients with an implanted artificial aortic vs. mitral valve, we found that in principle, as long as there are no complications, surgical implantation of an artificial aortic valve lasts shorter than surgical implantation of an artificial mitral valve. Referring to that, the heart arrest, or duration of cardioplegia and hypothermia are shorter during aortic valve surgery than during mitral valve surgery, that certainly can partly explained the obtained differences in results of this study [17,18]. Furthermore, by clamping the aorta, it must be, but very rarely is, separated from the lung artery and during that separation the part of the periaortal nerves can be damaged.…”

Section: Discussionmentioning

confidence: 69%

Heart rate variability in patients after cardiac valve surgery

Lakušić¹,

Slivnjak²,

Baborski³

et al. 2008

Open Medicine

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AbstractThe aim of study was to analyze heart rate variability (HRV) after different cardiac valve surgery procedures and the prognostic values of these findings. This study included 101 consecutive patients who underwent surgical implantation for an artificial valve. The mean age of the patients was 62 ± 10 years. An aortic valve was implanted in 65 patients. A mitral valve was implanted in 36 patients. HRV was analyzed from 24 hours Holter electrocardiographic (ECG) records. The time from the operation to the recording of Holter ECG and measuring HRV was 3.8 ± 1.4 months. After discharged from stationary cardiac rehabilitation, all involved patients were contacted to provide data on their health in the follow-up period (33 ± 21 months). A total of 46 patients with an implanted artificial valve had decreased overall HRV or standard deviation of all normal R-R intervals (SDNN) < 93 ms. Patients with an implanted artificial mitral valve had a shorter RR interval (817 ± 122 vs. 863 ± 122ms, p=0.03) and lower values of total power (1166 ± 1888 vs. 2802 ± 3601 ms2, p<0.001) compared to patients with an implanted artificial aortic valve. The results of study show that several months after cardiac surgery, almost half of the patients with an implanted artificial valve have decreased HRV. However, postoperative decreased HRV in those patients have no importance in long-term prediction of mortality rate.

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“…However, they were in opposition to the results reported by Tseng et al [15], where the HRV parameters recorded before PCI procedure did not differ significantly from those assessed directly after the PCI procedure. Moreover, many studies have demonstrated that coronary artery bypass grafting (CABG) also leads to significant HRV reduction, which is even more pronounced than after myocardial infarction [10][11][12][13]. In addition, HRV reduction after cardiac surgery is not exclusively related to PCI or CABG, as it is also recorded in patients undergoing valve surgery [14].…”

Section: Discussionmentioning

confidence: 99%

“…Studies have invariably demonstrated that coronary artery bypass grafting (CABG) also leads to significant HRV reduction [10][11][12][13]. In addition, HRV reduction after cardiac surgery is not exclusively related to PCI or CABG, as it is also recorded in patients undergoing valve surgery [14].…”

Section: Introductionmentioning

confidence: 99%

Effect of a Percutaneous Coronary Intervention Procedure on Heart Rate Variability and Pulse Transit Time Variability: A Comparison Study Based on Fuzzy Measure Entropy

Zhang

Liu

et al. 2016

Entropy

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Percutaneous coronary intervention (PCI) is a common treatment method for patients with coronary artery disease (CAD), but its effect on synchronously measured heart rate variability (HRV) and pulse transit time variability (PTTV) have not been well established. This study aimed to verify whether PCI for CAD patients affects both HRV and PTTV parameters. Sixteen CAD patients were enrolled. Two five-minute ECG and finger photoplethysmography (PPG) signals were recorded, one within 24 h before PCI and another within 24 h after PCI. The changes of RR and pulse transit time (PTT) intervals due to the PCI procedure were first compared. Then, HRV and PTTV were evaluated by a standard short-term time-domain variability index of standard deviation of time series (SDTS) and our previously developed entropy-based index of fuzzy measure entropy (FuzzyMEn). To test the effect of different time series length on HRV and PTTV results, we segmented the RR and PTT time series using four time windows of 200, 100, 50 and 25 beats respectively. The PCI-induced changes in HRV and PTTV, as well as in RR and PTT intervals, are different. PCI procedure significantly decreased RR intervals (before PCI 973˘85 vs. after PCI 907˘100 ms, p < 0.05) while significantly increasing PTT intervals (207˘18 vs. 214˘19 ms, p < 0.01). For HRV, SDTS-only output significant lower values after PCI when time windows are 100 and 25 beats while presenting no significant decreases for other two time windows. By contrast, FuzzyMEn gave significant lower values after PCI for all four time windows (all p < 0.05). For PTTV, SDTS hardly changed after PCI at any time window (all p > 0.90) whereas FuzzyMEn still reported significant lower values (p < 0.05 for 25 beats time window and p < 0.01 for other three time windows). For both HRV and PTTV, with the increase of time window values, SDTS decreased while FuzzyMEn increased. This pilot study demonstrated that the RR interval decreased whereas the PTT interval increased after the PCI procedure and that there were significant reductions in both HRV and PTTV immediately after PCI using the FuzzyMEn method, indicating the changes in underlying mechanisms in cardiovascular system.

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Alterations in Temporal Patterns of Heart Rate Variability after Coronary Artery Bypass Graft Surgery

Cited by 71 publications

References 0 publications

RR Interval Dynamics Before Atrial Fibrillation in Patients After Coronary Artery Bypass Graft Surgery

RR Interval Dynamics Before Atrial Fibrillation in Patients After Coronary Artery Bypass Graft Surgery

Heart rate variability in patients after cardiac valve surgery

Effect of a Percutaneous Coronary Intervention Procedure on Heart Rate Variability and Pulse Transit Time Variability: A Comparison Study Based on Fuzzy Measure Entropy

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