title: Electrocardiographic and vectorcardiographic findings of patients undergoing reductive ventriculectomy (Batista operation).
abstract: BACKGROUND
  The Batista operation, or partial ventriculectomy, has been designed by the Brazilian surgeon Dr. Randas Batista as an alternative method for treating patients with idiopathic dilated cardiomyopathy.
  
  
  OBJECTIVE
  This study aimed to analyze electro- and vectorcardiographic data obtained from patients who underwent such surgery, and to evaluate its electrical repercussions on the heart.
  
  
  METHODS
  Pre- and postoperative electrocardiography (ECG) and vectorcardiography (VCG) were performed 45 days apart in 15 patients undergoing reductive ventriculectomy.
  
  
  RESULTS
  All ECGs showed sinus rhythm, with unchanged QRS duration. Left atrial enlargement (86.6%) and left ventricular hypertrophy (100%) were the most common findings. Bundle-branch blocks (BBBs) were often demonstrated on preoperative studies, predominantly (46.7%) left BBBs. Left anterior fascicular blocks were seen in four patients (26.6%), one associated with right BBB. Electrocardiographic changes suggestive of myocardial infarction (MI) were seen in four patients preoperatively; postoperatively, all had extended to or within the lateral wall. Five additional patients developed lateral MIs postoperatively, for a total of 9 patients (60%) with postoperative signs of infarction (p < 0.05). Electro- and vectorcardiography also showed significant postoperative lowering of QRS voltages (mean 40.74%) in all patients and a consequent difficulty to diagnose left ventricular hypertrophy, although the morphologic features did not change.
  
  
  CONCLUSIONS
  These important ECG and VCG alterations are reflections of both the surgical technique and its clinical consequences.
authors.affiliation: Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. ecg_pastore@icor.usp.ob
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Pastore
authors.forename: Nancy
authors.initials: N
authors.lastname: Tobias
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kaiser
authors.forename: Fernando F
authors.initials: FF
authors.lastname: Bacal
authors.forename: José Luiz
authors.initials: JL
authors.lastname: Aziz
authors.forename: Luis Felipe
authors.initials: LF
authors.lastname: Moreira
authors.forename: Noedir
authors.initials: N
authors.lastname: Stolf
authors.forename: Edimar
authors.initials: E
authors.lastname: Bocchi
authors.forename: José Franchini
authors.initials: JF
authors.lastname: Ramires
mesh_terms: D000328:Adult; D000368:Aged; D002037:Bundle-Branch Block / Q000503:physiopathology; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology / Q000601:surgery*; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology; D011184:Postoperative Period; D011300:Preoperative Care; D014672:Vectorcardiography
chemical_list: D003402:Creatine Kinase