Continuous Ambulatory Ecg Monitoring in the Perioperative Period: Relationship of Preoperative Status and Outcome

Abstract

We have used continuous ambulatory electrocardiography in the perioperative period to monitor 108 patients with known cardiovascular disease undergoing non-cardiac surgery. There was a high incidence of ischaemic ST segment changes and ventricular arrhythmias. For the group as a whole, anaesthesia and surgery were followed by increased ventricular ectopic activity, but did not worsen myocardial ischaemia. However, the mean duration of ischaemic ST segment changes was increased significantly in those patients with treated hypertension. Of the risk factors considered, preoperative ischaemia and peroperative systolic arterial pressure were significant correlates with postoperative myocardial ischaemia.

Perioperative Continuous Monitoring of St-Segment Changes in Patients Undergoing Elective Caesarean Section

“…The Compas continuous ambulatory ECG monitoring system was used in our study. This has been found to be a sensitive system for the detection of ST-segment changes in the perioperative period [3,4]. Our definition of significant ST-segment changes, which is that accepted generally, was a depression of 1 mm or greater and elevation of 2 mm or greater that lasted longer than 1 min.…”

Perioperative myocardial ischaemia, heart rate and arrhythmia in patients undergoing thoracotomy: an observational study

“…For example, five deaths occurred after 72 h when myocardial ischaemia was not being monitored. McHugh and colleagues, 18 using the automated Compas system and a definition of myocardial ischaemia of ST elevation ^2 mm above baseline or depression s= 1 mm below baseline lasting more than 1 min, reported an incidence of myocardial ischaemia in high-risk patients undergoing non-cardiac surgery of 81%. This incidence of myocardial ischaemia was higher than reported in other studies, including those in high-risk patients.…”

The effect of edothelium on the response to propofol on bovine coronary artery rings

“…propofol is often accompanied by hypotension, which has been ascribed to a decrease in either systemic vascular resistance (1-4) or cardiac output (5), or both (6,7). The coronary artery effects of general anaesthetics are of a particular interest because 15% of all patients undergoing anacsthesia and surgery have underlying coronary artery disease (8,9).…”