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Computerizedvectorcardio-graphy for improved perioperative cardiac monitoring in vascularsurgery
Dept. of Anesth. and Intensive Care, Karolinska Institute, Karolinska, Sweden; .
Department of Cardiology, Karolinska Institute, Karolinska, Sweden; Danderyd Hospitals, Stockholm, Sweden.
Örebro University, School of Medical Sciences. Department of Surgery, Karolinska Institute, Karolinska, Sweden.ORCID iD: 0000-0003-2636-4745
1996 (English)In: Journal of the American College of Surgeons, ISSN 1072-7515, E-ISSN 1879-1190, Vol. 182, no 6, p. 530-536Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Postoperative cardiac complications occur frequently after noncardiac operations in high-risk patients. Routine cardiac monitoring is usually done by electrocardiographic (ECG) methods. The present analysis shows that computerizedvectorcardiography (VCG) is superior to traditional ECG monitoring in predicting postoperative cardiac complications.

STUDY DESIGN:

Thirty-eight patients scheduled for abdominal aortic operations were monitored intraoperatively and for 48 hours postoperatively using VCG. These data were analyzed in a blinded fashion, and compared to cardiac outcome and regularly calculated 12-lead ECGs.

RESULTS:

Thirteen patients suffered from cardiac events: myocardial infarction (n = 3), cardiac death (n = 1), recurrent myocardial ischemia (n = 1), arrhythmias (n = 2), congestive heart failure (n = 2), and arrhythmias combined with congestive heart failure (n = 4). Thirty of 38 patients had ischemia recorded on their VCG, including all 13 patients with cardiac events. Only seven of the 13 patients had ischemic changes on the V5-lead alone and ten on the three leads II, V4, V5, yielding a sensitivity of 54 percent (V5), 77 percent (II, V4, V5) and 100 percent (VCG). Signs of ischemia appeared 400 +/- 690 (mean plus or minus standard deviation) minutes earlier (median 78 minutes, with a range of zero to 2,284 minutes), and never later on the VCG compared to the three leads II, V4, V5.

CONCLUSIONS:

Vectorcardiography in this risk group shows increased sensitivity in predicting perioperative cardiac complications and earlier ischemia detection than the most sensitive scalar leads. Vectorcardiography substantially improves the possibility of earlier intervention, potentially reducing the incidence of postoperative cardiac complications.

Place, publisher, year, edition, pages
Elsevier, 1996. Vol. 182, no 6, p. 530-536
National Category
Surgery Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:oru:diva-63867ISI: A1996UP38000010PubMedID: 8646354Scopus ID: 2-s2.0-0029887339OAI: oai:DiVA.org:oru-63867DiVA, id: diva2:1171006
Available from: 2018-01-05 Created: 2018-01-05 Last updated: 2018-02-06Bibliographically approved

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