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Ann Thorac Surg 1983;36:314-319
© 1983 The Society of Thoracic Surgeons

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Articles

Electrical Behavior of the Heart Following High-Potassium Cardioplegia

From the Cardiovascular Research Unit, Royal Victoria Hospital, McGill University, Montreal, Canada

Accepted for publication September 19, 1982.

^* Address reprint requests to Dr. Morin, Royal Victoria Hospital, 687 Pine Ave W, Room S8.30, Montreal, PQ, Canada H3A 1A1

The electrical activity of the heart was studied in 25 patients undergoing elective coronary artery bypass grafting. Simultaneous surface electrocardiograms and bipolar atrial electrograms were monitored continuously from the onset of cardioplegic arrest until normal sinus rhythm was reestablished. Several observations were made.

(1) Administration of cardioplegia promptly induced and maintained ventricular arrest in all patients. (2) Atrial activity was seen in 23 patients during global ischemia. (3) Following unclamping, the first sustained rhythm was atrial in 22 patients and was associated initially with high-grade atrioventricular block progressing to 1:1 conduction after a mean reperfusion time of 23 minutes. (4) The time required for complete electrical recovery varied directly with the cross-clamp time and the amount of cardioplegic solution used. (5) Only 3 patients required ventricular defibrillation. (6) In the postoperative period, supraventricular tachyarrhythmias developed in 6 patients. Their occurrence appeared to be related to prolonged atrial activity during the cross-clamp period.

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