Supraventricular arrhythmias (SVA) following pulmonary resection have been well documented, although their reported incidence has varied widely. The purpose of this study was to retrospectively evaluate patients who have undergone a pulmonary resection in an effort to determine the incidence of and factors related to the development of postoperative SVA during the early post-pulmonary resection period (the first 7 postoperative days).
During the study period (1999-2003), 337 patients (244 men, 93 women) were included to this study. The primary end point with respect to efficacy was sustained (>15 minitues) or clinically significant SVA during the first 7 days after the operation. Frequencies observed in patients who experienced SVA and those who did not were compared by means of a chi-square test and Student’s t test for unpaired data.
The study comprised 337 patients whose age ranged from 39 to 83 years (mean age, 66.4 years). Four patients underwent pneumonectomy, 12 bilobectomy, 263 lobectomy, and 58 segmentectomy. Forty (11.9%) of the 337 patients developed SVA. One patient developed atrial flutter, 22 patients atrial fibrillation (af), 10 paroxysmal supraventricular tachycardia (PSVT), and 7 af & PSVT. The incidence of SVA in patients having pneumonectomy, bilobectomy, lobectomy, or segmentectomy was 0%, 0%, 13.3%, and 8.6%, respectively. SVA occurred in 32 (13.1%) men and in 8 (8.6%) women (N.S.). Patients experiencing SVA were older (p<0.05). Patients with SVA did not differ in preoperative pulmonary functional parameters from patients without SVA. Seventeen of 40 (42.5%) patients with SVA and 30 of 297 (10.1%) without SVA required bronchial toileting after operations (p<0.05). There was no difference in the incidence of major postoperative complications between patients with and without SVA.
Patients who developed SVA were older and almost half of them required bronchial toileting.
Since the causes of postoperative rhythm disturbances and the treatment of these arrhythmias will be completely understood, the prophylactic use of cardiac active drugs should be considered as the way to secure low-risk procedures, especially in elderly patients.
M. Takahama, None.