NGHIÊN CỨU ĐẶC ĐIỂM BIẾN THIÊN NHỊP TIM Ở BỆNH NHÂN TRƯỚC VÀ SAU PHẪU THUẬT CẦU NỐI CHỦ VÀNH

Abstract

Introduction and objectives: The heart rate variability in the patients pre and postoperative CABG measured by Holter ECG 24 hours are marker of ventricular dysfunction and indicates a poor prognosis as major adverse cardiovascular events. Autonomic heart rate control is impaired after coronary artery bypass grafting. The aim of this study was to establish the temporal pattern of change in the decrease of heart rate variability observed after coronary artery bypass grafting. Methods: cross sectional description. The study involved 119 consecutive patients with coronary artery disease were assessed with 24-hour Holter recordings 2 days before coronary artery bypass grafting and 1 week, 3 months, 6 months after coronary artery bypass grafting at Hanoi Heart Hospital from 6/2016 to 8/2018. Main results: All the time domain and frequency domain heart rate variability parameters decreased precipitately after CABG and were mostly recovered 3 months after coronary artery bypass grafting. Characteristics of low heart rate variation before surgery accounted for 28.6%, 51.8% after 7 days, 19.6% after 3 months and 12.7% after 6 months. In which, indicators of ASDNN and SDNN before and after surgery had the highest rate of change. Conclusions: The recovery of heart rate variability regardless to the preoperative state of the patients and their postoperative course implies that the early drop of heart rate variability after coronary artery bypass grafting was related to the acute effects of surgery. Late complete recovery of heart rate variability may be due to resolution of ischemia.