title: Cardioplegia and ventricular late potentials in cardiac surgical patients.
abstract: OBJECTIVE
  Ventricular late potentials (LP) recording with signal-averaged electrocar- diogram allow identifying patients at risk of sudden death and ventricular tachycardia. Cardiac surgery with cardiopulmonary bypass (CPB) could predispose to the development of myocardial ischemia related to imperfect cardioplegia. To the best of our knowledge, no study investigated the protection of cardioplegia and CPB regarding the occurrence of LP in patients without previous myocardial infarction and undergoing cardiac surgery.
  
  
  METHODS
  In 61 elective patients scheduled for cardiac surgery involving CPB, signal-averaged electrocar- diogram was performed the day before and 24-48 h after the surgery. The electrodes were positioned according to Frank's orthogonal derivations. Twenty five patients were excluded because of poor quality signals, leaving 36 patients (age, 64 ± 14) available for the analyses. An abnormal signal-averaged electrocardiogram was considered when ≥2 of the recorded indexes were present. McNemar's tests were performed on the dichotomized values to investigate differences in pre-post scores.
  
  
  RESULTS
  The mean CPB duration was of 110 ± 57 min. Patients scheduled for cardiac surgery do not exhibited LP after CPB (no significant difference in pre-post CPB scores, P = NS). The probability of a patient with a negative score transitioning to a positive score was 0.23 (P = NS).
  
  
  CONCLUSIONS
  The present study in cardiac surgical patients suggests that cardioplegia associated to CPB has no significant impact on the occurrence of LP, irrespective of surgery performed.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Schütz
authors.forename: J-A
authors.initials: JA
authors.lastname: Romand
authors.forename: N D
authors.initials: ND
authors.lastname: Yanez
authors.forename: M M
authors.initials: MM
authors.lastname: Treggiari
authors.forename: K
authors.initials: K
authors.lastname: Bendjelid
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control; D004562:Electrocardiography / Q000379:methods / Q000706:statistics & numerical data; D006324:Heart Arrest, Induced / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000517:prevention & control; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000517:prevention & control