[Changes in heart rhythm and conduction during surgical treatment of ischemic heart disease]

The effect of coronary flow recovery and/or aneurism resection on the pattern of conductivity disorders was examined in 76, and that of excitability disorders, in 35 patients. Aortal-coronary shunting eliminated ventricular extrasystole in 13 of 17 patients, normalized conductive function in all 12 patients with transitory block of the His bundle's anterior left branch, while their general clinical condition improved. Functional conductivity and excitability disorders due to scarry myocardial changes persisted in spite of revascularization procedure. Following aneurism resection, cardiac rhythm returned to normal in 5 of the 7 patients with ventricular extrasystole, while in 2 patients with paroxysmal atrial fibrillation paroxysms disappeared, a fact attributable to the removal of ectopic excitement focus and improved intracardiac hemodynamics. In all cases, conductivity and excitability improvement and normalization occurred during the early postoperative period and were maintained for long terms (up to ten years).