USE OF EPICARDIAL PACING WIRES AFTER CORONARY-ARTERY BYPASS-SURGERY

Objective: To replicate a previous study that described the incidence and characteristics of patients after coronary artery bypass graft sur gery who required the use of epicardial pacing wires and to explore th e reasons for epicardial pacing wire use in this patient population. D esign: Ex post facto descriptive correlational. Setting: Cardiothoraci c intensive care and step down units of a 500-bed medical center. Subj ects: Convenience sample of 196 patients after coronary artery bypass graft surgery, 165 who did not use the epicardial pacing wires and 31 who used the epicardial pacing wires to augment cardiac output, diagno se dysrhythmias, suppress dysrhythmias, or treat heart block. Patients receiving other surgical techniques in combination with coronary arte ry bypass graft surgery were not included. Procedure: Recording of dem ographic and clinical data for all of the sample population, with addi tional data collected when the epicardial pacing wires were used. Data Analysis: Independent t test and chi-square analysis were used to det ermine significance between the means and frequencies in the variables of the patients who used the epicardial pacing wires and those who di d not. The significance level was set at 0.05. Results: There were no statistically significant differences between the groups in terms of a ge or previous or recent myocardial infarction, which was opposite of the replicated study's findings. A statistically significant differenc e (p < 0.001) was found betwen the groups for the use of inotropic sup port, which was also opposite of the findings of that study. The group requiring epicardial pacing wire utilization demonstrated a greater n eed for diuretics in the preoperative phase than those who did not (p < 0.01), as well as a higher use of digitalis therapy before surgery ( p < 0.01). Additionally, those who were paced experienced a greater ca rdiac output (p = 0.013) and cardiac index (p = 0.018) after pacing wa s initiated. Conclusions: The variation in findings between this study and the one replicated may be the result of variations in the patient populations, treatment practices, or preoperative condition. Replicat ion of this study at a future date may reveal variables not identified here.