High resolution heart rate variability analysis in patients with angina pectoris during coronary artery bypass graft surgery

Abstract

The purpose of the study is approbation of the capabilities of high-resolution rhythmocardiography (RCG) for the determination of the actual cardiovascular status of operated patients with angina pectoris during coronary artery bypass graft surgery (CABGS) for myocardial revascularization. The research was done by means of a KAP-RK-02-Mikor hardware-software complex with a monitor record and the time- and frequency-domain analyses of heart rate variability (HRV). Monitor records were made at each stage of CABGS in 123 patients. As a result, HRV manifested itself as a fairly adequate and promising method for the determination of the cardiovascular status during CABGS. In addition, the data of the HRV study during CABGS testify to the capability of RCG to determine the high risk of life-threatening cardioarrhythmias before and during operation, to different changes in sinoatrial heart node (SN) dysregulation, and contain the HRV symptoms of a high death risk before, during and after shunting. The loss of the peripheral autonomic sympathetic and parasympathetic control in SN in the form of the autonomic cardioneuropathy syndrome is a predictor of the complications related to CABGS. The obtained data on RCG monitoring of HRV recording are suggestive of wide prospects of the high-resolution RCG method to be used in cardiac surgery as a whole. The actual multivariant dysregulations of SN pacemaker activity testify to its adequacy to the pathophysiology of each period of the cardiac operation, according to the initial ischemic damages and localization of cardiosurgical manipulations during CABGS.