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Maechler, HE; Lueger, A; Bergmann, P; Friehs, I; Stark, G; Berger, J; Anelli-Monti, M; Rehak, P; Rigler, B.
A high-resolution esophageal electrocardiogram for monitoring atrial activity in the hypothermic potassium-arrested heart.
Anesth Analg. 1997; 84(3):484-90 Doi: 10.1097/00000539-199703000-00003 [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Mächler Heinrich
Co-Autor*innen der Med Uni Graz
Anelli-Monti Michael
Lueger Andreas
Rehak Peter
Rigler Bruno
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Abstract:
Atrial electrical activities during hypothermic, K(+)-induced cardioplegic arrest correlate with an increased incidence of postoperative supraventricular dysrhythmias in coronary artery bypass graft patients. Surface electrocardiogram (ECG) (S-ECG) may be insufficiently sensitive to detect such activity intraoperatively, and invasive methods are impractical and traumatic. From induction of anesthesia until the end of surgery, esophageal ECG signals were detected with a new bipolar esophageal probe and a new high-resolution preamplifier (frequency range 0.01-2000 Hz). The S-ECG and the esophageal ECG (E-ECG) were evaluated independently in 18 patients. Eight of 18 patients presented during cardioplegic arrest a mean of 483 +/- 119 high-amplitude, biphasic P components (mean amplitude 0.7 +/- 0.1 mV, range 0.35-1.15 mV) per patient (mean 36 +/- 6 [5-59] potentials/min) similar to those coinciding with the surface ECG P-waves during sinus rhythm. Six of these eight patients presented a mean of 29 +/- 11 low atrial activities (mean amplitude 0.14 +/- 0.023 mV; range 0.1-0.25 mV) per patient (mean 8.4 +/- 5.6 [2.3-48] potentials/min) in the E-ECG. In the S-ECG, one patient of these eight presented 26 P waves during cardioplegic arrest simultaneously with activities in the E-ECG. During the first 5 days, seven of eight (88%) patients with atrial activities in the E-ECG versus 3 of 10 (30%) patients without atrial activities developed supraventricular tachyarrhythmias postoperatively (P < 0.05). This new high-resolution E-ECG device detected in a beat-to-beat technique more atrial activity during cardioplegic arrest than a S-ECG and offered the advantages of artifact exclusion and better prediction of postoperative supraventricular dysrhythmias.
Find related publications in this database (using NLM MeSH Indexing)
Aged - administration & dosage
Atrial Function - administration & dosage
Cold Temperature - administration & dosage
Electrocardiography - methods
Electrophysiology - administration & dosage
Esophagus - administration & dosage
Female - administration & dosage
Heart Arrest - administration & dosage
Heart Conduction System - physiology
Humans - administration & dosage
Male - administration & dosage
Middle Aged - administration & dosage
Potassium - administration & dosage

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