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Many bioelectric signals have a complex internal structure that can be a rich source of information on the tissue or cell processes. The structure of such signals can be analysed in detail by applying digital methods of signal processing. Therefore, of substantial use in diagnosis of the coronary arterial disease is the method of digital enhancement of increasing signal resolution ECG (NURSE-ECG), permitting detection of temporary changes in the electric potentials in the cardiac muscle in the process of depolarisation. Thanks to the application of NURSE-ECG it has become possible to detect relatively small changes in the electric activity of particular fragments of the cardiac muscle undetectable by the standard ECG method, caused by ischemia, the effect of a drug or infarct.The aim of this study was to identify and analyse changes in the electric activity of the cardiac muscle as a result of the Coronary Artery Bypass Graft (CABG) operation. In this study the method of NURSE-ECG has been applied in order to identify and analyse changes in the electric activity of the cardiac muscle as a result of the CABG operation. In the study performed in cooperation of the Institute of Physics Adam Mickiewicz University and the Strus Hospital, Cardiac Surgery Ward, 37 patients with advanced coronary arterial disease were asked to participate. The patients were examined prior to the operation, on the day after the operation and two months after the operation and a year after the operation. The ECG recordings were subjected to a numerical procedure of resolution enhancement by a NURSE-ECG program to reveal the tentative changes in the electric potential of the cardiac muscle on its depolarisation. Results of the study have shown that the NURSE ECG method can be applied to monitor changes in the electric activity of the cardiac muscle occurring as a result of CABG operation. One the second day after the operation in the majority of patients (70%) a rapid decrease of the total cardiac muscle activity was observed. The NURSE ECG seems to be a promising supplementary method in medical diagnosis. In particular it can be applied for qualification of patients for CABG operation and for verification of the operation effects.
Objectives Identifying factors predictive of early return to work in patients who underwent a coronary artery bypass graft surgery (CABG). Material and Methods Two hundred twenty-six working patients who volunteered and underwent a primary coronary artery bypass surgery between September 2013 and May 2014 were selected for the study and followed up for 6 months. Predictors of early return to work (RTW) (within 2 months) were analyzed from variables in a prospectively collected database and the 36-Item Short Form Health Survey (SF-36) questionnaire carried out in the hospital and rehabilitation center as well as from the follow-up performed via the phone. Results One hundred and two (45.1%) and 155 (68.9%) patients returned to work within 2 and 3 months after the surgery, respectively. Furthermore, 196 patients (87.1%) returned to work within 6 months after the surgery. In the univariate analysis, demographic or socioeconomic factors (such as age, level of education, income), occupational factors (such as occupation type, working hours per week, duration of the preoperative absence from work), psychological factors (such as a patient’s concern about adverse health effects of RTW, feeling depressed, a patient’s attitude towards his/her ability to RTW and a patient’s perception of his/her job stress level) and medical factors (such as serum troponin T and creatine kinase MB (CKMB) level, pump time in surgery, co-surgery and dyslipidemia history) had a statistically significant correlation with early return to work. The patients who early returned to work had significantly higher scores in 3 domains on the SF-36 questionnaire (used for assessing the patients’ quality of life), compared to those who did not return to work early (including physical functioning, role limitations due to physical health and pain). Conclusions In the present study we identified 4 new medical factors that could be used as predictors of early return to work after CABG. These factors are: normal serum troponin T level, shorter pump time in surgery, normal mean arterial pressure (MAP) before the surgery and higher serum magnesium (Mg) levels. Int J Occup Med Environ Health 2016;29(6):947–957
There is some evidence that focused and intense rehabilitation improve clinical outcome following conventional open-heart surgery. Recent developments in surgical techniques, which focused on the improvement in patient comfort, reduction in hospital stay and costs, has resulted in minimally invasive techniques, including Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) and Endoscopic Atraumatic Coronary Artery Bypass (EACAB). EACAB is safer than on-pump coronary artery bypass graft (CABG), especially in high risk patients. Its use, however, is limited to a small subgroup of patients: those with suitable anatomy of coronary pathology, younger patients with rapidly progressing coronary artery disease or elderly patients with substantial co-morbidities, whom sternotomy and cardiopulmonary bypass pose significant risks to. In this latter group of patients, effective rehabilitation is, therefore, even more important. Prevention of disturbances in homeostasis resulting from reduced physical activity, and thus rate of recovery and effectiveness of cardiac surgery, are not dependent on early physical activity and the intensiveness of the inpatient rehabilitation only but also on psychological therapy, dietary advice and health-promoting education. In this study, we explore differences in inpatient rehabilitation methods and outcomes between the groups of patients who underwent on-pump CABG and MIDCAB operations. Our data show that inpatient rehabilitation following MIDCAB operations may be shorter than after on-pump CABG by 2 days on average.
Introduction: Physical activity is important component of modern treatment after carried procedure coronary artery bypass graft, important effects of convalescing bringing. Purpose of this activity is correction of efficiency and modification of factor of risk. Material and methods: The examination group included 70 men aged 51 to 75 (59 ± 4,94). There were patients with stayed cardiac infarction, who have been undergo operation in period of week after stayed cardiac infarction of coronary artery bypass graft. Questionnaire Minnesota was used for evaluation of level of physical activity. The examination was carried out twice: I - one day before operation, II - after the period of 6 months after the procedure. First research had character of direct interview, but second has been carried by phone. Analysis included period 6 months before and after procedure 6 months CABG. The total weekly energy expenditure was calculated and divided on recreation activity and homeworks, and on intensity of physical activity: low, moderate and high. Results: Results allowed for description of level physical activity and range of weekly energy expenditure. Conclusions: Amount of implanted coronary artery bypass graft has influence on physical activity. Low and moderate effort predominated in analyzed group researched and with recreation activity.
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