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Electrocardiographic R-wave changes during cardiac surgery.

Publication ,  Journal Article
Mark, JB; Chien, GL; Steinbrook, RA; Fenton, T
Published in: Anesth Analg
January 1992

The diagnostic accuracy of exercise electrocardiography has been improved by incorporation of R-wave gain factor to correct the measured ST-segment changes. If marked changes in R-wave amplitude occur in individual patients during cardiac operations, a similar gain factor correction may improve the intraoperative diagnosis of myocardial ischemia. This investigation was designed to determine the frequency and magnitude of intraoperative V5 R-wave amplitude changes during cardiac operations. Electrocardiograms were recorded from 83 patients while patients were awake, anesthetized (baseline), after placement of the Favaloro and Canadian sternal retractors, and at end-operation. Compared with baseline values, placement of the Canadian sternal retractor was associated with a reduction in V5 R-wave amplitude from 15 +/- 1 to 10 +/- 1 mm (mean +/- SEM), in V5 S-wave amplitude from 3.5 +/- 0.4 to 1.7 +/- 0.3 mm, and in absolute ST-segment deviation from 0.50 +/- 0.04 to 0.39 +/- 0.05 mm. Changes in V5 R-wave amplitude were correlated with changes in ST-segment deviation in patients with baseline ST-segment deviations greater than or equal to 0.5 mm (r = 0.55, P = 0.0004, n = 37). Changes associated with the Favaloro retractor and the respiratory cycle were less marked. However, the V5 R-wave amplitude was decreased from 15 +/- 1 to 9 +/- 1 mm at end-operation. In conclusion, sternal spreading with the Canadian retractor was associated with marked reductions in V5 R- and S-wave amplitudes and ST-segment deviations. Marked changes in V5 R-wave amplitude persisted after sternal closure.(ABSTRACT TRUNCATED AT 250 WORDS)

Duke Scholars

Published In

Anesth Analg

DOI

ISSN

0003-2999

Publication Date

January 1992

Volume

74

Issue

1

Start / End Page

26 / 31

Location

United States

Related Subject Headings

  • Monitoring, Intraoperative
  • Male
  • Intraoperative Period
  • Humans
  • Heart Rate
  • Female
  • Electrocardiography
  • Cardiac Surgical Procedures
  • Blood Pressure
  • Anesthesiology
 

Citation

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MLA
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Mark, J. B., Chien, G. L., Steinbrook, R. A., & Fenton, T. (1992). Electrocardiographic R-wave changes during cardiac surgery. Anesth Analg, 74(1), 26–31. https://doi.org/10.1213/00000539-199201000-00005
Mark, J. B., G. L. Chien, R. A. Steinbrook, and T. Fenton. “Electrocardiographic R-wave changes during cardiac surgery.Anesth Analg 74, no. 1 (January 1992): 26–31. https://doi.org/10.1213/00000539-199201000-00005.
Mark JB, Chien GL, Steinbrook RA, Fenton T. Electrocardiographic R-wave changes during cardiac surgery. Anesth Analg. 1992 Jan;74(1):26–31.
Mark, J. B., et al. “Electrocardiographic R-wave changes during cardiac surgery.Anesth Analg, vol. 74, no. 1, Jan. 1992, pp. 26–31. Pubmed, doi:10.1213/00000539-199201000-00005.
Mark JB, Chien GL, Steinbrook RA, Fenton T. Electrocardiographic R-wave changes during cardiac surgery. Anesth Analg. 1992 Jan;74(1):26–31.

Published In

Anesth Analg

DOI

ISSN

0003-2999

Publication Date

January 1992

Volume

74

Issue

1

Start / End Page

26 / 31

Location

United States

Related Subject Headings

  • Monitoring, Intraoperative
  • Male
  • Intraoperative Period
  • Humans
  • Heart Rate
  • Female
  • Electrocardiography
  • Cardiac Surgical Procedures
  • Blood Pressure
  • Anesthesiology