Clinical and Echocardiographic Correlates of Symptomatic Tachydysrhythmias After Noncardiac Thoracic Surgery

Amar, David; Roistacher, Nancy; Burt, Michael; Reinsel, Ruth A.; Ginsberg, Robert J.; Wilson, Roger S.

doi:10.1378/chest.108.2.349

Cited by 159 publications

(99 citation statements)

References 21 publications

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“…Postoperative arrhythmia after thoracic surgery was thought to occur because of increased intraoperative blood loss and a postoperative increase in right heart pressure. 15 However, intraoperative arrhythmia might be caused by the intraoperative management, such as a lymph node dissection, or compression of the heart.…”

Section: Discussionmentioning

confidence: 99%

The results of surgery under general anesthesia in patients with lung cancer

et al. 2010

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Section: Discussionmentioning

confidence: 99%

The results of surgery under general anesthesia in patients with lung cancer

et al. 2010

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“…The relationship between the occurrence of postoperative AF and baseline predictors was assessed with multivariable logistic regression model adjusted for factors presumably associated with AF risk, including advanced age, male gender, COPD, cardiac diseases, hypertension and diabetes mellitus, site of anastomosis, postoperative hypoxia, thoracic-gastric dilation and plasma NT-proBNP [1,[22][23][24][25] . P < 0.05 was considered statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…Atrial fibrillation (AF) is a frequent arrhythmia after esophageal procedures and is associated with an increased morbidity and mortality and a longer, more expensive hospital stay [1][2][3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

Transrectal EUS-guided FNA biopsy of a presacral chordoma-report of a case and review of the literature

Hou

Gao²,

Li³

et al. 2008

WJG

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AIM:To evaluate the value of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) level for predicting postoperative atrial fibrillation (AF) in patients undergoing surgery for esophageal carcinoma. METHODS:NT-proBNP levels were measured in 142 patients 24 h before and 1 h after surgery for esophageal carcinoma. All patients having a preoperative cardiac diagnosis by electrocardiogram (ECG), remained under continuous monitoring for at least 48 h after surgery, and then underwent clinical cardiac evaluation until discharge.RESULTS: Postoperative AF occurred in 11 patients (7.7%). AF patients were significantly older (69.6 ± 12.2 years vs 63.4 ± 13.3 years, P = 0.031) than non-AF patients. There were no significant differences in history of diabetes mellitus, sex distribution, surgical approach, anastomosis site, intraoperative hypotension and postoperative fever. The preoperative plasma NT-proBNP level was significantly higher in patients who developed postoperative AF (121.3 ± 18.3 pg/mL vs 396.1 ± 42.6 pg/mL, P = 0.016). After adjustment for age, gender, chronic obstructive pulmonary disease (COPD), history of cardiac diseases, hypertension, postoperative hypoxia and thoracic-gastric dilation, NT-proBNP levels were found to be associated with the highest risk factor for postoperative AF (odds ratio = 4.711, 95% CI = 1.212 to 7.644, P = 0.008).CONCLUSION: An elevated perioperative plasma BNP level is a strong and independent predictor of postoperative AF in patients undergoing surgery for esophageal carcinoma. This finding has important implications for identifying patients at higher risk of postoperative AF who should be considered for preventive antiarrhythmic therapy.

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“…In some studies, AF has been found to be benign and transient, although it is associated with a prolonged length of hospitalization and high related costs, 9 -12 whereas, in others, it has been related to significantly increased morbidity and mortality. [13][14][15][16] …”

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confidence: 99%

Increased Perioperative N-Terminal Pro-B-Type Natriuretic Peptide Levels Predict Atrial Fibrillation After Thoracic Surgery for Lung Cancer

et al. 2007

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Background-Postoperative atrial fibrillation (AF) is a complication of thoracic surgery for lung cancer, with a reported incidence that can run as high as 42%. Recently, it has been observed retrospectively that B-type natriuretic peptide predicts AF after cardiac surgery. We performed a prospective study to evaluate the role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) as a marker for risk stratification of postoperative AF in patients undergoing thoracic surgery for lung cancer. Methods and Results-We measured NT-proBNP levels in 400 patients (mean age, 62Ϯ10 years; 271 men) 24 hours before and 1 hour after surgery. The primary end point of the study was the incidence of postoperative AF. Overall, postoperative AF occurred in 72 patients (18%). Eighty-eight patients (22%) showed an elevated perioperative NT-proBNP value. When patients with either preoperatively or postoperatively elevated NT-proBNP were pooled, a greater incidence of AF was observed compared with patients with normal values (64% versus 5%; PϽ0.001). At multivariable analysis, adjusted for age, gender, major comorbidities, echocardiography parameters, pneumonectomy, and medications, both preoperative and postoperative NT-proBNP values were independent predictors of AF (relative risk, 27.9; 95% CI, 13.2 to 58.9; PϽ0.001 for preoperative NT-proBNP elevation; relative risk, 20.1; 95% CI, 5.8 to 69.4; PϽ0.001 for postoperative NT-proBNP elevation). Conclusions-Elevation of perioperative NT-proBNP is a strong independent predictor of postoperative AF in patients undergoing thoracic surgery for lung cancer. This finding should facilitate studies of therapies to reduce AF in selected high-risk patients.

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Clinical and Echocardiographic Correlates of Symptomatic Tachydysrhythmias After Noncardiac Thoracic Surgery

Cited by 159 publications

References 21 publications

The results of surgery under general anesthesia in patients with lung cancer

The results of surgery under general anesthesia in patients with lung cancer

Transrectal EUS-guided FNA biopsy of a presacral chordoma-report of a case and review of the literature

Increased Perioperative N-Terminal Pro-B-Type Natriuretic Peptide Levels Predict Atrial Fibrillation After Thoracic Surgery for Lung Cancer

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