Work

Study of pattern of perioperative ECG and echocardiographic changes in the patients with aneurysmal subarachnoid haemorrhage

Year: 2015

Type: conference-paper

Abstract: Background: The objectives of the study were: Primary: Perioperative pattern of Electrocardiography (ECG) and Echocardiographic (Echo) changes till seven days following surgical clipping. Secondary: i) Incidence of ECG and Echo Changes following aneurysm rupture. ii) Association of ECG and Echo Changes with Clinical Grades, time elapse from Ictus to hospital admission, site of bleed and location of aneurysm. iii) Association of ECG and echo changes with intraoperative ionotropic requirement. Materials and Methods: This prospective, observational study was conducted in the patients undergoing clipping with subarachnoid hemorrhage (SAH) secondary to aneurysm rupture. Patients with known cardiac disease and unfit for surgery, were excluded from the study. Baseline parameters, such as, Blood Pressure, Heart Rate, ECG, Echo; Hunt and Hess, WFNS and Fisher’s Scores were recorded. ECG and Echo changes were recorded preoperatively and till seven days following surgery. Serum electrolytes were kept within the normal range. Results: 100 patients were enrolled. 75 patients developed ECG Changes and17 patients developed Echo changes preoperatively, including global hypokinesias and RWMA. Various ECG observed were QTc prolongation, conduction defects, ST and T wave abnormalities, tachyarrhythmias and bradyarrhythmias. Both echocardiographic and ECG changes, such as, QTc prolongation and bradycardia showed significant recovery on postoperative day-1 and 2 ( P < 0.05). Other ECG changes did not show significant recovery during study period. We did not find association between ECG and echo changes. ECG changes were not associated with increased intraoperative ionotropic requirement but patients with Echo changes were found to have significant high ionotropic requirement. None of the patients had perioperative cardiogenic shock. Conclusion: Early therapeutic intervention can hasten the recovery of these changes by taking care of intracranial pathology. ECG and Echo changes were not associated with clinical grades, time elapse between ictus and admission, location of aneurysm or bleed.

Source: Journal of Neuroanaesthesiology and Critical Care

DOI: 10.1055/s-0038-1667524