Comparison of the Incidences of Cardiac Arrhythmias, Myocardial Ischemia, and Cardiac Events in Patients Treated With Endovascular Versus Open Surgical Repair of Abdominal Aortic Aneurysms

• Published in: The American journal of cardiology 2007-11, Vol.100 (9), p.1479-1484
• Main Authors: Feringa, Harm H.H., MD, Karagiannis, Stefanos, MD, Vidakovic, Radosav, MD, Noordzij, Peter G., MD, Brugts, Jasper J., MD, Schouten, Olaf, MD, van Sambeek, Marc R.H.M., MD, Bax, Jeroen J., MD, Poldermans, Don, MD
• Format: Article
• Language: English
• Subjects: Aged; Aneurysms; Aortic Aneurysm, Abdominal - surgery; Arrhythmias, Cardiac - epidemiology; Atrial Fibrillation - epidemiology; Biological and medical sciences; Blood and lymphatic vessels; Blood Vessel Prosthesis Implantation; Cardiac arrhythmia; Cardiac dysrhythmias; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Coronary heart disease; Coronary vessels; Diseases of the aorta; Echocardiography, Stress; Electrocardiography; Female; Heart; Heart Rate - physiology; Humans; Male; Medical sciences; Multivariate Analysis; Myocardial Ischemia - epidemiology; Myocarditis. Cardiomyopathies; Prospective Studies; Stents; Tachycardia, Ventricular - epidemiology; Treatment Outcome; Troponin T - blood; Vascular Surgical Procedures
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2007.06.043

This study examines differences in cardiac arrhythmias, perioperative myocardial ischemia, troponin T release, and cardiovascular events between endovascular and open repair of abdominal aortic aneurysms (AAAs). Of 175 patients, 126 underwent open AAA repair and 49 underwent endovascular AAA repair. Continuous 12-lead electrocardiographic monitoring, starting 1 day before surgery and continuing through 2 days after surgery, was used for cardiac arrhythmia and myocardial ischemia detection. Troponin T was measured on postoperative days 1, 3, and 7 and before discharge. Cardiac events (cardiac death or Q-wave myocardial infarction) were noted at 30 days and at follow-up (mean 2.3 years). New-onset atrial fibrillation, nonsustained ventricular tachycardia, sustained ventricular tachycardia, and ventricular fibrillation occurred in 5%, 17%, 2%, and 1% of patients, respectively. Myocardial ischemia, troponin T release, and 30-day and long-term cardiac events occurred in 34%, 29%, 6%, and 10% of patients, respectively. Significantly higher heart rates and less heart rate variability were observed in the open AAA repair group. Cardiac arrhythmias were less prevalent in the endovascular AAA repair group (14% vs 29%, p = 0.04). Endovascular repair was also significantly associated with less myocardial ischemia (odds ratio 0.14, 95% confidence interval 0.05 to 0.40, p