Predicting of Postoperative Cardiac Events Using Ambulatory ECG Monitoring Prior to Abdominal Aortic Surgery

Objectives: The purpose of this study was to estimate the value of preoperative electrocardiographic (ECG) monitoring in predicting postoperative cardiac events in patients undergoing abdominal aortic surgery. Design: A prospective open study. Setting: University Hospital. Materials: One hundred consecutive patients were studied before aortic or aortofemoral surgery by ambulatory ECG monitoring for 24 hours. Chief Outcome Measures: An ischaemic episode by ECG criteria was defined as a ≥ 1 mm horizontal or downsloping ST segment depression measured 60 msec after the J point and persisting for at least 40 sec. Main Results: Twenty-four patients had preoperative ambulatory ischaemia. Twenty patients had postoperative cardiac events including three with fatal myocardial infarction, one with a nonfatal infarction, eight with unstable angina, three with pulmonary oedema and five with atrial fibrillation. Sixteen out of 24 (67%) patients with ambulatory ischaemia had postoperative cardiac events ( p p Conclusions: Preoperative ECG monitoring for myocardial ischaemia could non-invasively identify patients at high risk for postoperative cardiac morbidity and mortality after vascular surgery.