Nonlinear Heart Rate Dynamics in Off-pump Coronary Artery Bypass Grafting Patients and The Relevance with Atrial Fibrillation and Ventricular Tachycardia

摘要

Objectives To elucidate the clinical relevance of nonlinear HRV with postoperative arrhythmias in patients undergoing off-pump CABG. Methods Twenty-seven elective off-pump CABG patients were recruited in the present study. Atrial fibrillation (AF), ventricular tachycardia (VT), linear and nonlinear HRV were analysed using 24-hour electrocardiogram before and after surgery. Results All time domain (SDNN, pNN50 and rMSSD), frequency domain (LF and HF) of linear measures of HRV variables and nonlinear measures of HRV variable, the short-term fractal-like correlation α1 decreased significantly after surgery. The postoperative nonlinear HRV variable α1 tended to be lower in patients with postoperative AF (P=0.056). Significant depressed α1was found in patients with postoperative VT (P=0.022). Elder patient's age and longer inotropic treatment time negatively correlated with postoperative α1.Conclusions Off-pump CABG procedures resulted in significant depressed of linear and nonlinear HRV variables. The depressed nonlinear HRV variables α1related to age, inotropic supports and postoperative AF and VT.