on November 18, 2002
Published online before print November 18, 2002, doi: 10.1161/01.CIR.0000041430.32233.5B
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Submitted on July 31, 2002
From the Division of Cardiac Surgery, Department of Surgery (Z.-K.W., E.P., J.L., M.R.T.) and Department of Clinical Physiology (T.I.), Tampere University Hospital, Tampere, Finland. * To whom correspondence should be addressed. E-mail: matti.tarkka{at}tays.fi.
Background—Ventricular fibrillation (VF) and tachycardia (VT) are the common and potential life-threatening complications after CABG. Ischemic preconditioning (IP) has been proved effective in reducing ischemia reperfusion arrhythmia in animals and humans. Whether IP is effective in suppressing postoperative VF/VT in patients with CABG has not been studied. Methods and Results—Eighty-six patients with CABG with stable and unstable 3-vessel disease were equally randomly assigned into an IP and a control group. The patients who received IP received 2 periods of 2-minute ischemia followed by 3-minute reperfusion. Twenty-four-hour electrocardiographic data were collected. IP resulted in fewer cases of VF after declamping (48.8% versus 79.1% in IP and control, P=0.004) and a shorter VF period (2.28±0.44 versus 4.41±0.51 minutes, P=0.002). The episodes of VT were significantly reduced in patients in the IP group during early reperfusion and 24 hours after reperfusion (0.65±0.16 versus 3.71±0.46, P=0.000 and 0.07±0.04 versus 2.12±1.41, P=0.002, respectively). De novo sustained VT occurred in 3 control patients as against none in the IP group after surgery. As a result, IP significantly curtailed the mechanical ventilation period and reduced the need for inotropes. Conclusions—IP significantly reduced postoperative VF/VT in patients with CABG with 3-vessel disease. Suppression of VT during early reperfusion and 24 hours after reperfusion suggests early and delayed IP phenomena in patients undergoing CABG surgery.
Revised on September 19, 2002
Accepted on September 22, 2002
Ischemic Preconditioning Suppresses Ventricular Tachyarrhythmias After Myocardial Revascularization
Zhong-Kai Wu MD,
Key words: ischemia • ventricles • tachycardia • fibrillation • reperfusion
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Circulation 2002 106: 2999-3001.
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