ECG Changes after CABG: The Role of the Surgical Technique

Giuseppe Crescenzi, Anna Mara Scandroglio, Federico Pappalardo, Giovanni Landoni, Valeria Cedrati, Elena Bignami, Giacomo Aletti, Alberto Zangrillo

Research output: Contribution to journalArticlepeer-review


Objective: The purpose of this study was to determine whether coronary artery bypass grafting (CABG) surgery on the beating heart (BH) is associated with reduction of R-wave potentials on the precordial leads on the surface electrocardiogram (ECG) as previously shown for CABG with cardiopulmonary bypass. Methods: Fifty-four patients undergoing CABG surgery at a single tertiary care university hospital were analyzed. Patients suffering a postoperative cardiac event (myocardial infarction) or nonspecific ECG changes were excluded. ECG results were recorded at arrival in the intensive care unit, after 4 and 18 hours postoperatively; simultaneously, myocardial cell damage biomarkers (CK-MB and cTnI) were assayed. A control group of 31 patients undergoing mitral valve repair was also evaluated. Results: Patients operated with the BH (OPCABG) technique did not show any decrease of R-wave amplitude at 0, 4, and 18 hours postoperatively; whereas those operated with CPB, both for coronary artery surgery and for mitral repair, had a similar extent and pattern of R-wave reduction. The release of myocardial necrosis markers was significantly lower in coronary artery patients operated with BH than in those operated with CPB; however, no statistically significant correlation between the ECG changes and release of myocardial cell damage markers was observed in any of the groups. Conclusions: The findings indicate, for the first time, that CABG surgery on the BH is not followed by any reduction of R-wave amplitude on precordial leads and confirms that the BH technique is associated with a lower release of myocardial cell damage markers.

Original languageEnglish
Pages (from-to)38-42
Number of pages5
JournalJournal of Cardiothoracic and Vascular Anesthesia
Issue number1
Publication statusPublished - Feb 2004


  • Coronary artery bypass grafting
  • OPCAB vs. CABG with CPB
  • Perioperative infarction
  • Postoperative electrocardiogram

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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