title: Feasibility of neuromuscular electrical stimulation immediately after cardiovascular surgery.
abstract: OBJECTIVE
  To determine the safety and feasibility of neuromuscular electrical stimulation (NMES) from postoperative days (PODs) 1 to 5 after cardiovascular surgery.
  
  
  METHODS
  Pre-post interventional study.
  
  
  METHODS
  Surgical intensive care unit and thoracic surgical ward of a university hospital.
  
  
  METHODS
  Consecutive patients (N=144) who underwent cardiovascular surgery were included. Patients with peripheral arterial disease, psychiatric disease, neuromuscular disease, and dementia were excluded. Patients with severe chronic renal failure and those who required prolonged mechanical ventilation after surgery were also excluded because of the possibility of affecting the outcome of a future controlled study.
  
  
  METHODS
  NMES to the lower extremities was implemented from PODs 1 to 5.
  
  
  METHODS
  Feasibility outcomes included compliance, the number of the patients who had changes in systolic blood pressure (BP) >20 mmHg or an increase in heart rate >20 beats/min during NMES, and the incidence of temporary pacemaker malfunction or postoperative cardiac arrhythmias.
  
  
  RESULTS
  Sixty-eight of 105 eligible patients participated in this study. Sixty-one (89.7%) of them completed NMES sessions. We found no patients who had excessive changes in systolic blood pressure, increased heart rate, or pacemaker malfunction during NMES. Incidence of atrial fibrillation during the study period was 26.9% (7/26) for coronary artery bypass surgery, 18.2% (4/22) for valvular surgery, and 20.0% (4/20) for combined or aortic surgery. No sustained ventricular arrhythmia or ventricular fibrillation was observed.
  
  
  CONCLUSIONS
  The results of this study demonstrate that NMES can be safely implemented even in patients immediately after cardiovascular surgery.
authors.affiliation: Program in Physical and Occupational Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Iwatsu
authors.affiliation: Department of Rehabilitation Science, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: yamadas@met.nagoya-u.ac.jp.
authors.forename: Sumio
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Program in Physical and Occupational Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Physiotherapy, Kainan Hospital, Aichi, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Iida
authors.affiliation: Program in Physical and Occupational Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sampei
authors.affiliation: Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Surgical Intensive Care Division, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Motoshi
authors.initials: M
authors.lastname: Kainuma
authors.affiliation: Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Usui
mesh_terms: D000368:Aged; D001794:Blood Pressure; D013504:Cardiovascular Surgical Procedures / Q000534:rehabilitation*; D004558:Electric Stimulation / Q000379:methods*; D005260:Female; D006339:Heart Rate; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period
keywords: Arrhythmias, cardiac; Cardiovascular surgical procedures; Electric stimulation therapy; Hemodynamics; Rehabilitation