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

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.

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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

Irmandade Santa Casa Misericordia Hosp, Araraquara, Brazil

Univ Illinois, Coll Appl Hlth Sci, Dept Phys Therapy, Chicago, IL USA

Universidade Federal de São Paulo, Escola Paulista Med, Cardiol Discipline, São Paulo Hosp, São Paulo, Brazil

Universidade Federal de São Paulo, Phys Therapy Sch, Dept Human Movement Sci, Santos, Brazil

Universidade Federal de São Paulo, Escola Paulista Med, Cardiol Discipline, São Paulo Hosp, São Paulo, Brazil

Universidade Federal de São Paulo, Phys Therapy Sch, Dept Human Movement Sci, Santos, Brazil

FAPESP: 2005/59427-7

FAPESP: 2009/54194-5

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