title: Does the type of venous drainage or cardioplegia affect postoperative conduction and atrial arrhythmias?
abstract: Five consecutive patient groups undergoing coronary bypass surgery were studied for postoperative conduction disturbances and atrial arrhythmias. Group I (50 patients) had blood cardioplegic solution (25 meq/liter potassium) and unsnared venae cavae, group II (156 patients) had low-volume crystalloid cardioplegic solution (25 meq/liter potassium) and unsnared venae cavae, group III (56 patients) was similar to group II except that a single cavoatrial venous cannula was used instead of two separate cannulas, group IV (218 patients) had high-volume crystalloid cardioplegic solution (25 meq/liter potassium) and snared venae cavae, and group V (37 patients) was the same as group IV except that the cardioplegic solution contained 10 meq/liter potassium after the first dose, which contained 25 meq/liter. All postoperative electrocardiograms were analyzed for conduction disturbances and atrial arrhythmias. The results showed a significantly lower incidence of conduction disturbances in group I (12%) as compared with groups II to IV. In addition, groups IV and V (high-volume crystalloid cardioplegic solution) had a significantly higher incidence of conduction disturbances than groups II and III (lower-volume crystalloid solution) (55.0% and 62.1% vs 26.2% and 35.1%, respectively). The majority of these disturbances were temporary. Group I also had the lowest incidence of postoperative atrial arrhythmias (3.8%). There was no significant difference between the groups receiving high- and low-volume crystalloid solution. It is concluded that blood cardioplegic solution affords the best protection against postoperative conduction disturbances and atrial arrhythmias. High-volume crystalloid cardioplegic solution affords the least protection against conduction disturbances but has no effect on atrial arrhythmias.(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D001145:Arrhythmias, Cardiac / Q000145:classification / Q000209:etiology*; D001803:Blood Transfusion; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D004322:Drainage / Q000009:adverse effects* / Q000379:methods; D006324:Heart Arrest, Induced / Q000009:adverse effects* / Q000379:methods; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D011188:Potassium; D017680:Potassium Compounds; D012189:Retrospective Studies; D014684:Venae Cavae
chemical_list: D017680:Potassium Compounds; C018369:potassium cardioplegic solution; D011188:Potassium