Frequency and structure of cardiac arrhythmias in the early postoperative period following cardiac surgery
Authors: Danilevych TD , Rasputina LV , Mostovoy YM , Belinskyi AV 
Published: May 2021

Funding Acknowledgements

Type of funding sources: None.

Background. Cardiac arrhythmias occupy one of the key places in the structure of complications of the early postoperative period following cardiac surgery. According to various literature sources, they range from 10% to 40% and often determine the course of the postoperative period.

Purpose. To determine the frequency and structure of cardiac arrhythmias in the early postoperative period in the patients following cardiac surgery (up to 7 days).

Methods. 56 patients were examined, among them 19 (33.9%) men and 37 (66,1%) women (p = 0.02). The age of patients ranged from 31 to 79 years, averaging 60.86 ± 8.87 years. Cardiac surgery was performed for coronary heart disease in 37 (66.1%) and valvular heart defects in 19 (33.9%) patients (p = 0.02). The duration of the operation ranged from 240 to 600 minutes, averaging 371.94 ± 102.04 minutes. In 25 (44.6%) cases, the operations were performed in conditions of bypass, the average duration of which did not differ from operations without bypass (389.44 ± 116.88 vs. 355.47 ± 86.16, p = 0.34). Assessment of cardiac arrhythmias was performed during the first 7 days after cardiac surgery. Statistical processing was performed by SPSS 12.0 for Windows.

Results. 27 (48.2%) patients have developed arrhythmias within first 7 days of the postoperative period, among them in 12 (63.2%) women and 15 (40.5%) men (p = 0.24). Analysis of age structure showed that the patients &lt;45 years didn’t have arrhythmias, 45-59 years - 8 (14.2%), 60-74 - 17 (30.4%), 75-90 - 2 (3,6%) of the patients have rhythm disorders, respectively.

Atrial fibrilation (AF) dominates in the structure of arrhythmias - 17 (30.4%) patients, among them – in 11 (64.7%) patients was paroxysmal,  in 6 (35.3%) – persistent form. The mean score of CHA2DS2VASc scale - 2.56 ± 0.89.

Also registered

atrial flutter –  in 3 (5.4%), atrial tachycardia –  in 2 (3.6%), supraventricular paroxysmal tachycardia –  in 1 (1.8%), frequent supraventricular premarute beats (PB) – in 11 (19.6%) ), ventricular PB – in 12 (21.4%), among them ventricular PB 1st Laun class  - 8 (66.7%), 2nd class - 2 (16.7%), 3rd class - 1 (8.3%), class 4A - 1 (8.3%) patients, respectively.

Among the heart blocks were registered

left bundle branch (LBB) block – in 4 (7.1%), anterior branch block of LBB – in 10 (17.9%), right bundle branch block – in 6 (10.7%), atrio-ventricular (AV) block 1 degree – in 4 (7.1%), complete AV block – in 8 (14.3%) patients, respectively. The implantation of the pacemaker was performed in 9 (16.1%) patients.

Disorders of repolarization

flattening / inversion of the T wave – in 31 (55.4%), elevation of the ST segment – in 5 (8.9%), depression of the ST segment – in 16 (28.6%), pathological Q wave – in 5 (8.9%) patients, respectively.

Conclusions

The prevalence of arrhythmias in the early postoperative period (7 days) following cardiac surgery is 48.2%, equally common in men and women. AF dominated in the structure of cardiac arrhythmias (30,4%).