Beat-to-beat QT interval variability before and after cardiac surgery.
Non-uniform recovery of excitability may be essential in triggering malignant ventricular tachycardia after cardiac surgery. Thirty-five channels ECG was recorded for 6 min in 27 patients before and after heart surgery and in 20 control subjects. Off-line analysis was performed. RR interval duration, RR SD, QT SD and power spectra of RR variability were computed from 256 s stable RR and QT interval series. When compared to controls, patients had decreased RR SD and increased QT SD before surgery (p<0.002 and p<0.0005, respectively); RR SD further decreased and QT SD increased after the surgery (p<0.0001 and p<0.0002, respectively). Increase of QT variability and decrease of RR variability after cardiac surgery may reflect disrupted electrophysiological stability of the myocardium and thus electrophysiological substrate for triggering malignant arrhythmia.
Department of Cardiovascular Surgery, University Medical Center, Zaloska, 7, Ljubljana 1000, Slovenia.
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Frljak
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Avbelj
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Trobec
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Meglic
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Ujiie
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Gersak
D000368:Aged; D000465:Algorithms; D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D018780:Body Surface Potential Mapping; D006348:Cardiac Surgical Procedures; D016022:Case-Control Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012815:Signal Processing, Computer-Assisted