scholarly journals Effect of Cardiac Rehabilitation on Atrial Conductions Following Isolated Coronary Artery Bypass Surgery

Author(s):  
Anil Sahin ◽  
Omer Tasbulak ◽  
Serkan Kahraman ◽  
Gokhan Demirci ◽  
Hicaz Zencirkiran Agus ◽  
...  

Background: Cardiac rehabilitation (CR) is associated with improved clinical outcomes in a broad spectrum of cardiac disease. The beneficial effect of CR has been proven in patients with ischemic heart diseases. Post-operative atrial fibrillation (AF) and atrial arrhythmias are common complications following coronary artery bypass grafting (CABG) surgery. The aim of this study was to evaluate the effect of CR on atrial conductions in patients who underwent isolated CABG surgery. Methods: After the exclusion criterion was applied 545 patients were included in the study, retrospectively. One group (Rehab +) included patients who participated in CR program and the other group (Rehab -) included patients who did not want to or could not be participated in CR program after isolated CABG surgery. ECG parameters of Pmax, Pmin and P wave dispersion (PWD) of both groups were compared. Results: All parameters including heart rate, PR interval, Pmax, Pmin and PWD were significantly changed in rehab (+) group after CABG surgery. There was significant change in rehab (+) group when compared to rehab (-) group in terms of parameters of Pmax (P<0.001), Pmin (P<0.001), P wave dispersion (P<0.001). Conclusion: Our findings referred that CR program significantly improved parameters of atrial conduction including Pmax, Pmin and PWD following isolated CABG surgery. Thereby improvement in atrial conduction by CR program following CABG surgery could reduce atrial arrhythmias.

2019 ◽  
pp. 204748731988601 ◽  
Author(s):  
Maya Sadeh ◽  
Michael Brauer ◽  
Alexandra Chudnovsky ◽  
Arnona Ziv ◽  
Rachel Dankner

Aims Physical activity is a fundamental component of rehabilitation following coronary artery bypass (CABG) surgery. Proximity to neighbourhood green spaces may encourage physical activity. We investigated the association between residential greenness and exercise-related physical activity post-CABG surgery. Methods Participants in a prospective cohort study of 846 patients (78% men) who underwent CABG surgery at seven cardiothoracic units during the time period 2004–2007 were interviewed regarding their physical activity habits one day before and one year after surgery. Exposure to residential neighbourhood greenness (within a 300 m buffer around their place of residence) was measured using the Normalized Difference Vegetative Index. Participation in exercise-related physical activity (yes/no), weekly duration of exercise-related physical activity and the change in exercise-related physical activity between baseline and follow-up were examined for associations with residential greenness, adjusting for socio-demographic factors, propensity score adjusted participation in cardiac rehabilitation and health-related covariates after multiple imputation for missing variables. Results Living in a higher quartile of residential greenness was associated with a 52% greater odds of being physically active (OR 1.52, 95% CI 1.22–1.90). This association persisted only (OR 1.75, 95% CI 1.35–2.27) among patients who did not participate in cardiac rehabilitation following surgery and was stronger in women (OR 2.38, 95% CI 1.40–4.07) than in men (OR 1.37, 95% CI 1.07–1.75). Participants who lived in greener areas were more likely to increase their post-surgical physical activity than those who lived in less green areas (OR 1.59, 95% CI 1.25–2.01). Conclusions Residential greenness appears to be beneficial in increasing exercise-related physical activity in cardiac patients, especially those not particpating in cardiac rehabilitation after CABG surgery.


2021 ◽  
pp. 57-60
Author(s):  
Md Anwar Sadat Halder ◽  
Saumen Kumar De

Introduction: Throughout the world, cardiovascular disease is a leading cause of not only morbidity but also mortality too. Myocardial infarction is the primary reason for admission in cardiac rehabilitation unit, patients of Coronary artery bypass Graft (CABG) surgery along with other cardiac condition like valve surgery, post PTCA (Percutaneous Transluminal Coronary Angioplasty) are also being referred for cardiac rehabilitation. Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG) surgery, is a surgical procedure for partially obstructed coronary artery (the "target vessel"). The purpose is to restore normal blood ow to the partially obstructed coronary artery. Our study is an attempt to understand the age, gender and risk factors pattern in patients attending for cardiac rehabilitation after Coronary Artery Bypass Grafting (CABG) Surgery. Material And Methods: This Retrospective Cohort Study was conducted in the Department of Physical Medicine and Rehabilitation of Institute of Post Graduate Medical Education and Research (IPGME & R) and SSKM Hospitals, Kolkata after getting Institutional ethical committee clearance and informed consent. Relevant data regarding medical, personal history and demographics collected from the patients attended for cardiac rehabilitation (CR) after coronary artery bypass grafting (CABG) surgery between January, 2014 to June, 2015 (18 months) were being used for analysis. Results: Data were summarised by routine descriptive statistics. Maximum number of patients are in the age group of 51-60 years. Most of study population are male (90%). Study showed show 42.5 % are smoker, 37.5 % diabetic, 27.5 % are obese, 82.5 % are dyslipidaemic, 57.5 % are hypertensive. Conclusion: Our study shows most of our patient is male of 5th decade. Minimum age is 46-year, maximum age is 71 years with the mean age 55.4 years. most of study population are male (90%). Among the study population, 42.5 % are smoker, 37.5 % diabetic, 27.5 % are obese, 82.5 % are dyslipidaemic, 57.5 % are hypertensive. Hence male sex is an important risk factor for coronary artery disease. Early and aggressive attention to these risk factors e.g., smoking, diabetes, obesity, dyslipidaemia, hypertension could drastically reduce the need for coronary procedures such as angioplasty, stent, and bypass surgeries.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Dankner ◽  
L Orenstein ◽  
K Laufer ◽  
L Olmer ◽  
A Ziv ◽  
...  

Abstract Objectives We investigated associations with re-hospitalization, and intermediate- and long-term mortality, of cardio-thoracic surgeons' adherence to pharmacological guideline-directed medical therapy (GDMT) in discharge recommendations of coronary artery bypass graft (CABG) surgery patients. Methods In this longitudinal multicenter study, 1,131 patients who underwent elective CABG surgery in seven medical centers during 2004–2007 were interviewed in the hospital before surgery. Adherence of cardio-thoracic surgeons to GDMT was considered as prescribing medications from three families: antiplatelet therapy, beta-blockers and statins; and was determined from discharge letters. Patients were interviewed one-year after hospitalization to obtain information on re-hospitalizations and current medications. Mortality information was extracted from the Ministry of Internal Affairs registry and updated until March 2018. Results GDMT adherence was evident in the discharge recommendations of 638 patients (56.4%). A propensity score (PS)-weighted multivariate logistic regression showed a 26% lower 1-year risk of re-hospitalization/mortality among patients whose discharge recommendations reflected full adherence than among patients whose recommendations reflected partial adherence (OR=0.74, 95% CI: 0.57–0.97, p=0.03). A PS-weighted Cox proportional hazard model showed 24% lower intermediate (8 year)-term mortality hazard among patients with cardio-thoracic surgeons' adherence to GDMT, compared to other patients (HR=0.76, 95% CI: 0.59–0.98, p=0.03); however the protective effect was attenuated when examining long (14 year)-term mortality. Short- and intermediate-term protective effects were also found when considering only adherence to beta-blockers or statins. Use of GDMT increased 1-year after CABG surgery only in patients who attended cardiac rehabilitation programs after surgery and not in those who did not attend cardiac rehabilitation during that year. Conclusions The reference in CABG patients' discharge recommendations to GDMT was associated with a lower 1-y re-admissions/mortality and lower intermediate-term mortality. Cardio-thoracic surgeons should adhere closely to preventive medication guidelines. Cardiac rehabilitation is associated with better post CABG surgery patients preventive treatment. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Israel National Institute for Health Policy


2015 ◽  
Vol 18 (4) ◽  
pp. 171 ◽  
Author(s):  
Tolga Demir ◽  
Mehmet Umit Ergenoglu ◽  
Hale Bolgi Demir ◽  
Nursen Tanrikulu ◽  
Mazlum Sahin ◽  
...  

<strong>Background</strong>: This study was undertaken to determine whether methylprednisolone could improve myocardial protection by altering the cytokine profile toward an anti-inflammatory course in patients undergoing elective coronary artery bypass grafting (CABG) surgery with cardiopulmonary bypass (CPB).<br /><strong>Methods</strong>: Forty patients who were scheduled for elective CABG surgery were randomized into two groups: the study group (n = 20), who received 1 g of methylprednisolone intravenously before CPB, and the control group (n = 20), who underwent a standard CABG surgery without any additional medication. Blood samples were withdrawn prior to surgery (T1) and then 4 hours (T2), 24 hours (T3), and 36 hours (T4) after CPB. Plasma levels of interleukin (IL)-6, IL-10, creatine kinase isoenzyme MB (CK-MB), cardiac troponin-t (cTnT), and blood glucose as well as neutrophil counts were measured at each sampling time. <br /><strong>Results</strong>: A comparison of patients between both groups revealed significantly high levels of IL-6 in the control group at T2, T3, and T4 with respect to T1 (T2: P &lt; .001; T3: <br />P &lt; .001; T4: P &lt; .001). IL-10 levels were significantly higher in the study group at T2 compared with the control group <br />(P = .007). CK-MB levels were significantly lower in the study group than in the control group at T4 (P = .001). The increase of cTnT was higher in the control group at T3 and T4 compared with the study group (T3: P = .002; T4: P = .001).<br /><strong>Conclusions</strong>: This study demonstrates that methylprednisolone is effective for ensuring better myocardial protection during cardiac surgery by suppressing the inflammatory response via decreasing the levels of IL-6 and by increasing anti-inflammatory activity through IL-10.<br /><br />


2021 ◽  
Vol 10 (4) ◽  
pp. 818
Author(s):  
Stefan Reichert ◽  
Susanne Schulz ◽  
Lisa Friebe ◽  
Michael Kohnert ◽  
Julia Grollmitz ◽  
...  

Periodontitis is a risk factor for atherosclerosis and coronary vascular disease (CVD). This research evaluated the relationship between periodontal conditions and postoperative outcome in patients who underwent coronary artery bypass grafting (CABG). A total of 101 patients with CVD (age 69 years, 88.1% males) and the necessity of CABG surgery were included. Periodontal diagnosis was made according to the guidelines of the Centers for Disease Control and Prevention (CDC, 2007). Additionally, periodontal epithelial surface area (PESA) and periodontal inflamed surface area (PISA) were determined. Multivariate survival analyses were carried out after a one-year follow-up period with Cox regression. All study subjects suffered from periodontitis (28.7% moderate, 71.3% severe). During the follow-up period, 14 patients (13.9%) experienced a new cardiovascular event (11 with angina pectoris, 2 with cardiac decompensation, and 1 with cardiac death). Severe periodontitis was not significant associated with the incidence of new events (adjusted hazard ratio, HR = 2.6; p = 0.199). Other risk factors for new events were pre-existing peripheral arterial disease (adjusted HR = 4.8, p = 0.030) and a history of myocardial infarction (HR = 6.1, p = 0.002). Periodontitis was not found to be an independent risk factor for the incidence of new cardiovascular events after CABG surgery.


2017 ◽  
Vol 8 (1) ◽  
pp. 200-207
Author(s):  
Sarah Farukhi Ahmed ◽  
Audrey Xi Tai ◽  
Mason Schmutz ◽  
John Combs ◽  
Sameh Mosaed

Importance: The purpose of this case report is to evaluate risk factors associated with post-coronary artery bypass graft (CABG) ocular hypotony compared to post-CABG ischemic optic neuropathy. Observations: The patient described here is a single case at the University of California, Irvine Medical Center, from July 2016. This case demonstrates the rare incidence of acute post-CABG ocular hypotony and vision loss in a patient with prior history of optic atrophy. Both vision loss and hypotony resolved completely to baseline without intervention within 3 days postoperatively. Conclusions and Relevance: Severe anemia and large fluctuations in central venous pressure and blood pressure can occur in any patient undergoing CABG surgery. These hemodynamic shifts can cause transient ischemia to pressure controlling systems such as the ciliary body and reduce episcleral venous pressure. Other risk factors for acute hypotony in the setting of CABG surgery also include the use of hypertonic agents, cardiopulmonary bypass, and intravenous anesthesia.


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