[1]Yan'An Hospital of Kunming City, China.
OBJECTIVES To study the role of heart rate management for cardiac functional repair of 56 cases that received coronary artery bypass grafting (CABG) surgery attacking electrical storm. METHODS A total of 56 cases with post-CABG operative electrical storm in our hospital from 2011-01 to 2015-06 were retrospectively analyzed. The pre-operative basic clinical information, in-operative condition and post-operative hemodynamic were summarized in all ones. RESULTS All patients were happened electrical storm who received CABG. However, the different causes of electrical storm were found and the origins of ventricular arrhythmia were located in these cases. They were treated with remove the disease inducement, electrical conversion under continuous ECG monitoring, pacemaker overdrive suppression and intravenous injection of heart rate controlling or combined with anti-arrhythmia medication. Further, 53 cases that including 11 cases depressed cardiac function compared to pre-operative were cured and 3 cases died. The difference is statistically significant between EF, CK, CK-MB, cTnI (95% CI: 1.025 to 1.364, P<0.05) and NT-ProBNP (P<0.01) in the groups of Pre-attack Electrical Storm and Heart Rate Management after Electrical Storm as well as the groups of Pre-attack Electrical Storm and Pre-operation. The value of cTnI in group of Heart Rate Management after Electrical Storm (2.19±0.56) (pg/ml) exceeded than the group of Pre-operation (0.03±0.01) (pg/ml) (P<0.05). In addition, factors lead to a racing rate such as smoking and agitation and factors with blood pressure disorder and internal environment disturbance are closely related with electrical storm attacking (r=0.517, P<0.05; r=0.429, P<0.05; r=0.653, P<0.05). CONCLUSIONS Efficient heart rate management could increase the cardiac functional impairment in virtue of electrical storm. We could make the heart rate management as the preferred treatment strategy for electrical storm.
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