Electrocardiographic changes during selective aortocoronary saphenous vein bypass graft angiography in man

Abstract

Simultaneous leads I, II, and III of the electrocardiogram were recorded during selective aortocoronary saphenous vein bypass graft angiography in 20 patients. Arrhythmias associated with such graft opacification included sinus bradycardia, sinus arrest, atrial premature beats, ventricular premature beats, ventricular tachycardia and two episodes of ventricular fibrillation. Rhythm disturbances were unrelated to the anatomic location of the grafts. Patent right graft injection effected a mean rightward frontal plane QRS axis shift of 32.7 ° with leftward T wave axis deviation. A majority of subjects with patent aortic-left anterior descending coronary arterial grafts also manifested right axis shift (mean 22.6 °), possibly related to collateral circulation between the left and right coronary arterial systems. Those patients with stenosed and occluded grafts had minimal or no electrocardiographic changes during bypass angiography. It is concluded that electrocardiographic alteration during graft angiography is a physiologic demonstration of aortocoronary bypass efficacy.