Relation between QRS changes and left ventricular function after coronary artery bypass grafting.

Abstract

Preoperative and serial postoperative electrocardiograms (ECGs) were reviewed in 104 patients undergoing rest and exercise radionuclide angiocardiography before and 1 to 12 months after coronary artery bypass grafting (CABG). Five patient groups were defined by ECG findings before and after CABG: Group I--normal ECG before and no ECG change after CABG; Group II--prior myocardial infarction by ECG before but no QRS change after CABG; Group III--all patients with a minor QRS change (less than 0.04-second Q wave, loss of R-wave amplitude) after CABG; Group IV--all patients with a major QRS change (greater than or equal to 0.04-second Q wave) after CABG; Group V--all patients without new Q waves or loss of R-wave amplitude but with a major QRS change (conduction disturbance) after CABG. Mean resting ejection fraction changed little after CABG in all groups, although the 0.03 increase in Group I was significant (p less than 0.05). Group IV had the largest decrease in resting ejection fraction after CABG (0.04), but this was not statistically significant. Mean exercise ejection fraction increased significantly (p less than 0.0001) in Groups I, II and III but not in Groups IV and V. QRS changes do not consistently reflect impairment of left ventricular (LV) function after CABG.