Intraoperative and postoperative arrhythmias in patients undergoing non-cardiac surgery

Abstract

Introduction: Frequency of arrhythmias and especially postoperative atrial fibrillation (AF) in non-cardiothoracic surgeries is lower compared to cardiothoracic ones, ranging from 12%-19% after abdominal surgery and reaching up to 4.8% after total joint replacement. Postoperative AF develops between the 1st and 4th day after surgery and often limits patients’ recovery.
The aim of this study was to assess the frequency and type of arrhythmia in patients undergoing gastrointestinal and orthopedic surgery.
Material and Methods: In the present cross-sectional study were enrolled 151 patients undergoing gastrointestinal and orthopedic surgery in a provincial hospital. Data were collected using the method of interview as well as were retrieved from patients’ medical records and files. The significance level was set at 0.05.
Results: From 151 participants, 60% were women, 67.3% were aged>65 years, 52.7% underwent gastrointestinal surgery and 47.3% orthopedic. Regarding comorbidity, arterial hypertension was reported by 85.1%, diabetes mellitus by 27.3%, AF/other arrythmia by 26.5%, dyslipidemia by 38.8% and heart failure by7.4%. Smokers were 23.3% of participants, alcohol was consumed by 15.3% while 56.5% used to drink Greek coffee. During hospitalization arrythmia was observed in 29.3% of participants while at admission 26.5% declared AF /other arrythmia. Postoperative complications and AF were more frequent in patients aged >80 years (p<0.001), (p=0.012) respectively, patients who underwent orthopedic surgery (p=0.001), (p=0.007) respectively, those receiving anticoagulants agents (p<0.001), (p=0.004) respectively, and participants reporting a cardiac disease in their medical history (p=0.058), (p=0.008), respectively.
Conclusions: Postoperative complications and postoperative AF were associated with age, surgery type, anticoagulants agents and medical history of cardiac disease. Prevention and treatment of both arrhythmias and complications associated with surgery requires detailed preoperative, intraoperative, and postoperative monitoring.