Møller M, Thayssen P, Alstrup P, Haghfelt T, Andersen P E
Eur Heart J. 1983 Jan;4(1):26-30. doi: 10.1093/oxfordjournals.eurheartj.a061367.
The effect of coronary artery bypass surgery (CAB) on ventricular arrhythmias (VA) was studied in a prospective investigation involving 32 patients (mean age 54 years) who underwent CAB because of severe stable angina pectoris. Prior to CAB as well as 12 months later each patient was subjected to the following investigational programme: resting ECG, exercise ECG, 24-h ECG, selective coronary arteriography, ventriculography and cardiac catheterization. Exercise ECG showed VA in only three patients. The prevalence of VA during 24-h ECG was 56 and 66% on the two occasions (NS), while complicated VA (multiform, repetitive, R on T) was seen in 18 and 28%, respectively (NS). The persistence (number of 6-h periods showing VA) was 33 and 47% with regard to any VA (P less than 0.05), while complicated VA occurred in 13 and 15% of the 6-h periods (NS). Except for an increase in dp/dtmax/P at the postoperative measurement (P less than 0.05), no significant change in the performance of the left ventricle was seen after CAB though the graft patency was 77%. It is concluded that in patients with 'medically intractable' stable angina pectoris, CAB does not effect the occurrence of VA to any great extent--probably because left ventricular function is unchanged one year after as compared with that prior to CAB.
在一项前瞻性研究中，对32例（平均年龄54岁）因严重稳定型心绞痛接受冠状动脉搭桥术（CAB）的患者，研究了该手术对室性心律失常（VA）的影响。在CAB术前以及术后12个月，每位患者均接受以下检查项目：静息心电图、运动心电图、24小时心电图、选择性冠状动脉造影、心室造影和心导管检查。运动心电图仅在3例患者中显示有VA。两次24小时心电图检查中VA的发生率分别为56%和66%（无显著性差异），而复杂性VA（多形性、重复性、R波落在T波上）分别见于18%和28%的患者（无显著性差异）。任何VA的持续时间（显示VA的6小时时段数）分别为33%和47%（P<0.05），而复杂性VA出现在6小时时段的13%和15%的患者中（无显著性差异）。除了术后测量时dp/dtmax/P增加（P<0.05）外，尽管移植血管通畅率为77%，但CAB术后左心室功能未见明显变化。结论是，在患有“药物治疗难以控制”的稳定型心绞痛患者中，CAB在很大程度上不影响VA的发生——可能是因为与CAB术前相比，术后一年左心室功能未改变。
