Recovery of linear and nonlinear heart rate dynamics after coronary artery bypass grafting surgery

Author(s)

Falasco Pantoni, Camila Bianca ^[1] ; Mendes, Renata Goncalves ^[1] ; Di Thommazo-Luporini, Luciana ^[1] ; Simoes, Rodrigo Polaquini ^[1] ; Amaral-Neto, Othon ^[2] ; Arena, Ross ^[3] ; Guizilini, Solange ^{[4, 5]} ; Gomes, Walter Jose ^[4] ; Catai, Aparecida Maria ^[1] ; Borghi-Silva, Audrey ^[1]

Affiliation

^[1] Univ Fed Sao Carlos, Cardiopulm Physiotherapy Lab, Nucleus Res Phys Exercise, BR-13560 Sao Carlos, SP - Brazil

^[2] Irmandade Santa Casa Misericordia Hosp, Araraquara - Brazil

^[3] Univ Illinois, Coll Appl Hlth Sci, Dept Phys Therapy, Chicago, IL - USA

^[4] Univ Fed Sao Paulo, Escola Paulista Med, Cardiol Discipline, Sao Paulo Hosp, Sao Paulo - Brazil

^[5] Univ Fed Sao Paulo, Phys Therapy Sch, Dept Human Movement Sci, Santos - Brazil

• Document type: Journal article
• Source: CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING; v. 34, n. 6, p. 449-456, NOV 2014.
• Web of Science Citations: 6

Abstract

Background: Conventional coronary artery bypass grafting (C-CABG) and off-pump CABG (OPCAB) surgery may produce different patients' outcomes, including the extent of cardiac autonomic (CA) imbalance. The beneficial effects of an exercise-based inpatient programme on heart rate variability (HRV) for C-CABG patients have already been demonstrated by our group. However, there are no studies about the impact of a cardiac rehabilitation (CR) on HRV behaviour after OPCAB. The aim of this study is to compare the influence of both operative techniques on HRV pattern following CR in the postoperative (PO) period. Methods: Cardiac autonomic function was evaluated by HRV indices pre- and post-CR in patients undergoing C-CABG (n = 15) and OPCAB (n = 13). All patients participated in a short-term(approximately 5 days) supervised CR programme of early mobilization, consisting of progressive exercises, from active-assistive movements at PO day 1 to climbing flights of stairs at PO day 5. Results: Both groups demonstrated a reduction in HRV following surgery. The CR programme promoted improvements in HRV indices at discharge for both groups. The OPCAB group presented with higher HRV values at discharge, compared to the C-CABG group, indicating a better recovery of CA function. Conclusion: Our data suggest that patients submitted to OPCAB and an inpatient CR programme present with greater improvement in CA function compared to C-CABG. (AU)