Ischemic Electrocardiographic Changes After Truncal Vagotomy

Abstract

Preoperative and postoperative evaluation (including clinical cardiac status, electrocardiograms, and serum enzyme levels) of 106 patients undergoing transabdominal truncal vagotomy during a 17-month period produced evidence of ischemic ECG abnormalities. Although ischemic ECG changes have been reported in patients with subarachnoid hemorrhage, as well as in those with metabolic and gastrointestinal disorders, such findings, to our knowledge, have not been previously documented in vagotomized humans. A 9% occurrence of moderate to marked ischemia with prolonged QT interval exceeds fourfold the highest reported incidence of postoperative myocardial infarction. The ECG abnormalities were noted primarily one day after vagotomy, lasted one to several weeks, and were not accompanied by correlative clinical or serum enzyme level changes. All patients undergoing vagotomy should have ECGs performed preoperatively and postoperatively.