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Effects of Transcutaneous Acupoint Electrical Stimulation on Postoperative HRV and Hs-cTnT of Elderly With CHD

Not Applicable
Completed
Conditions
Anesthesia
Coronary Artery Disease
Interventions
Procedure: transcutaneous acupoint electrical stimulation
Procedure: sham transcutaneous acupoint electrical stimulation
Registration Number
NCT03418194
Lead Sponsor
Hebei Medical University Third Hospital
Brief Summary

The aim of this study was to observe the effect of transcutaneous acupoint electrical stimulation (TAES) on postoperative heart rate variability and high-sensitive cardiac troponin T of elderly patients with coronary heart disease.

Detailed Description

General anesthesia can inhibit sympathetic nerve activity and attenuate stress response, but it also inhibits vagus nerve activity. The decrease of vagus nerve activity can cause cardiovascular complications, especially ventricular arrhythmia in patients with coronary heart disease. Some study have shown that electrical stimulation of transcutaneous acupoints can regulate the function of autonomic nervous system and enhance the activity of vagus nerve so as to protect myocardial tissue. But the effect on autonomic nervous function and myocardial injury markers in elderly patients with coronary heart disease was not reported. Heart rate variability (HRV) is a noninvasive and reliable index reflecting cardiac autonomic nervous function. High-sensitive cardiac troponin hs-cTnT is the best myocardial injury marker.

The investigators plan to recruite 150 patients with coronary heart disease of both sexes, aged 65-80 yr, undergoing elective lumbar decompression and fusion internal fixation surgery. They will be randomly divided into 2 groups(n=75 each)using random number table : control group ( group C ) and TAES group (group T). Patients in group T receive TEAS (disperse-dense waves, frequency 4/20Hz) at the points of PC6 (Neiguan) and PC4 (Ximen) from 30 min before anesthesia induction to the end of surgery, the optimal intensity will be adjusted to maintain a slight twitching of the midfinger or ring finger (De-Qi response). Patients in group C receive electrode plate at the same acupoints without any electrical stimulation. Heart rate variability will be collected on 1 day before surgery, 1, 3 and 5d after surgery. 3mL of venous blood will be collected before the induction of anesthesia, 1, 3 and 5d after surgery, the serum will be isolated for the measurement of serum concentration of high-sensitive troponin T (hs-cTnT)、CK、CRP.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
137
Inclusion Criteria
  • Stable angina pectoris
  • Slilent myocardial ischemia
  • Remote myocardial infarction
Exclusion Criteria
  • Congenital heart disease
  • Have a history of cardiac surgery
  • Frequent ventricular / atrial premature beats, atrial fibrillation and other serious arrhythmia
  • Heart conduction diseases
  • Antiarrhythmic drugs used
  • Temporary and permanent pacemaker used
  • Intraoperative blood loss>800ml

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
TAES grouptranscutaneous acupoint electrical stimulationPatients in group TAES group received transcutaneous acupoint electrical stimulation (disperse-dense waves, frequency 4/20Hz) at the points of PC6 (Neiguan) and PC4 (Ximen) from 30 min before anesthesia induction to the end of surgery,
control groupsham transcutaneous acupoint electrical stimulationPatients in group C received electrode plate atthe points of PC6 (Neiguan) and PC4 (Ximen) without any electrical stimulation.
Primary Outcome Measures
NameTimeMethod
High-sensitive cardiac troponin T1 week

Cardiac troponin T are components of the contractile apparatus of myocardial cells and are expressed almost exclusively in the heart. High-sensitive cardiac troponin T is cardiac troponin T mesured by high-sensitive method.

Secondary Outcome Measures
NameTimeMethod
heart rate variability1 week

Heart rate variability (HRV) has been verified as a noninvasive indicator of the autonomic nervous system.

CRP1 week

CRP is a non-specific biomarker of inflammation which has been described as a risk factor for cardiovascular disease. 1, 3 and 5d after surgery, the serum concentration of CRP.

CK1 week

CK is an indicator that reflects the amplitude of operation injury in spine surgery. 1, 3 and 5d after surgery, the serum concentration of CK.

Trial Locations

Locations (1)

Third Hospital of Hebei Medical Universit

🇨🇳

Shijiazhuang, Hebei, China

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