Ischemic preconditioning significantly reduced the incidence of ventricular fibrillation after declamping compared to control (48.8% vs 79.1%, P=0.004) in patients undergoing CABG.
RCT (n=86)
Equally randomly assigned
Does ischemic preconditioning reduce postoperative ventricular tachyarrhythmias in patients undergoing CABG with 3-vessel disease?
Ischemic preconditioning during CABG significantly reduces postoperative ventricular tachyarrhythmias, mechanical ventilation time, and inotrope requirement.
Absolute Event Rate: 48.8% vs 79.1%
p-value: p=0.004
BACKGROUND: Ventricular fibrillation (VF) and tachycardia (VT) are the common and potential life-threatening complications after CABG. Ischemic preconditioning (IP) has been proved effective in reducing ischemia reperfusion arrhythmia in animals and humans. Whether IP is effective in suppressing postoperative VF/VT in patients with CABG has not been studied. METHODS AND RESULTS: Eighty-six patients with CABG with stable and unstable 3-vessel disease were equally randomly assigned into an IP and a control group. The patients who received IP received 2 periods of 2-minute ischemia followed by 3-minute reperfusion. Twenty-four-hour electrocardiographic data were collected. IP resulted in fewer cases of VF after declamping (48.8% versus 79.1% in IP and control, P=0.004) and a shorter VF period (2.28+/-0.44 versus 4.41+/-0.51 minutes, P=0.002). The episodes of VT were significantly reduced in patients in the IP group during early reperfusion and 24 hours after reperfusion (0.65+/-0.16 versus 3.71+/-0.46, P=0.000 and 0.07+/-0.04 versus 2.12+/-1.41, P=0.002, respectively). De novo sustained VT occurred in 3 control patients as against none in the IP group after surgery. As a result, IP significantly curtailed the mechanical ventilation period and reduced the need for inotropes. CONCLUSIONS: IP significantly reduced postoperative VF/VT in patients with CABG with 3-vessel disease. Suppression of VT during early reperfusion and 24 hours after reperfusion suggests early and delayed IP phenomena in patients undergoing CABG surgery.
Wu et al. (Tue,) conducted a rct in CABG with stable and unstable 3-vessel disease (n=86). Ischemic preconditioning vs. Control was evaluated on Ventricular fibrillation after declamping (p=0.004). Ischemic preconditioning significantly reduced the incidence of ventricular fibrillation after declamping compared to control (48.8% vs 79.1%, P=0.004) in patients undergoing CABG.