Spontaneous ventricular fibrillation occurring immediately after institution of cardiopulmonary bypass

Possible clinical implications

Tomas Salerno, H. J. Stefaniszyn

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Twenty-four patients developed spontaneous ventricular fibrillation (SVF), for no apparent reasons, immediately after the institution of cardiopulmonary bypass (CPB) and prior to aortic cross-clamping and cardioplegic arrest. These were compared to 76 similar patients who remained in normal sinus rhythm (NSR). The following observations were made: (1) SVF occurred more frequently in patients undergoing urgent coronary bypass and having unstable or crescendo angina with severe triple coronary artery disease and/or left main coronary artery stenosis; (2) in nonvented hearts the mean left atrial pressure increased to levels above 28 mm Hg during SVF and prior to cardioplegic arrest; (3) at the end of CPB, arrhythmias and episodes of ventricular fibrillation were common (48% SVF versus 8% NSR); (4) the overall myocardial infarction rate was 37% SVF versus 4% NSR; and (5) the mortality rates were 25% SVF versus 1.3% NSR. It is postulated that the occurrence of SVF at the start of CPB may be indicative of serious derangements in myocardial cellular metabolism and/or function and may have clinical and prognostic implications.

Original languageEnglish
Pages (from-to)306-309
Number of pages4
JournalJournal of Thoracic and Cardiovascular Surgery
Volume86
Issue number2
StatePublished - Jan 1 1983
Externally publishedYes

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Ventricular Fibrillation
Cardiopulmonary Bypass
Atrial Pressure
Coronary Stenosis
Constriction
Cardiac Arrhythmias
Coronary Artery Disease
Myocardial Infarction
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

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abstract = "Twenty-four patients developed spontaneous ventricular fibrillation (SVF), for no apparent reasons, immediately after the institution of cardiopulmonary bypass (CPB) and prior to aortic cross-clamping and cardioplegic arrest. These were compared to 76 similar patients who remained in normal sinus rhythm (NSR). The following observations were made: (1) SVF occurred more frequently in patients undergoing urgent coronary bypass and having unstable or crescendo angina with severe triple coronary artery disease and/or left main coronary artery stenosis; (2) in nonvented hearts the mean left atrial pressure increased to levels above 28 mm Hg during SVF and prior to cardioplegic arrest; (3) at the end of CPB, arrhythmias and episodes of ventricular fibrillation were common (48{\%} SVF versus 8{\%} NSR); (4) the overall myocardial infarction rate was 37{\%} SVF versus 4{\%} NSR; and (5) the mortality rates were 25{\%} SVF versus 1.3{\%} NSR. It is postulated that the occurrence of SVF at the start of CPB may be indicative of serious derangements in myocardial cellular metabolism and/or function and may have clinical and prognostic implications.",
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AU - Salerno, Tomas

AU - Stefaniszyn, H. J.

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N2 - Twenty-four patients developed spontaneous ventricular fibrillation (SVF), for no apparent reasons, immediately after the institution of cardiopulmonary bypass (CPB) and prior to aortic cross-clamping and cardioplegic arrest. These were compared to 76 similar patients who remained in normal sinus rhythm (NSR). The following observations were made: (1) SVF occurred more frequently in patients undergoing urgent coronary bypass and having unstable or crescendo angina with severe triple coronary artery disease and/or left main coronary artery stenosis; (2) in nonvented hearts the mean left atrial pressure increased to levels above 28 mm Hg during SVF and prior to cardioplegic arrest; (3) at the end of CPB, arrhythmias and episodes of ventricular fibrillation were common (48% SVF versus 8% NSR); (4) the overall myocardial infarction rate was 37% SVF versus 4% NSR; and (5) the mortality rates were 25% SVF versus 1.3% NSR. It is postulated that the occurrence of SVF at the start of CPB may be indicative of serious derangements in myocardial cellular metabolism and/or function and may have clinical and prognostic implications.

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