Perioperative Arrhythmias and Acute Right Heart Failure in Noncardiac Thoracic Surgery

Abstract

Perioperative arrhythmias after non-cardiac thoracic surgery, with atrial fibrillation (AF) being the most common, have a reported incidence of 18 % and are directly proportional to the increasing age of the patient and whether an anatomical lung or esophageal resection is done. When sustained for more than 48 hours, AF is associated with an increased risk of thromboembolic events. Hospital and intensive care unit (ICU) lengths of stay are increased as well as costs. Great effort is placed in identifying patients at risk to target appropriate prophylaxis. Acute right ventricular failure is a rare occurrence in patients at risk such as those with pulmonary hypertension, left ventricular failure, and undergoing a right pneumonectomy. The goal of this review is to highlight the current management of perioperative arrhythmias and right heart failure.

Perioperative Cardiac Arrhythmias: An Approach

“…Perioperative arrhythmias after non-cardiac thoracic surgery are commonly supraventricular in origin, affecting 18-20 % of the cases. 4, 5,7 Diagnostic Evaluation: The prevention of peri-operative arrhythmias is of paramount importance and demands the following factors to be considered: 1. A proper pre-operative history of heart disease, lung disease and drug intake is to be elicited and detailed physical examination to exclude these illnesses is necessary.…”