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J Thorac Cardiovasc Surg 2004;127:629-630
© 2004 The American Association for Thoracic Surgery

Editorial

The problem of atrial arrhythmias after noncardiac thoracic surgery

Lawrence L. Creswell, MDa,*

a University of Mississippi Medical Center, Jackson, Miss, USA

Received for publication September 30, 2003; accepted for publication October 6, 2003.

* Address for reprints: Lawrence L. Creswell, MD, University of Mississippi Medical Center, 2500 North State St, Jackson, MS 39216, USA
lcreswell@surgery.umsmed.edu

The first 20% of the full text of this article appears below.


Dr Creswell



See related article on page 779.

 

The problem of postoperative atrial fibrillation (AF) has received considerable attention over the years. Nonetheless, this is probably still the most common complication in adult patients undergoing cardiac surgery and one of the most common complications in adult patients undergoing noncardiac thoracic surgery.

Perhaps because of effective antiarrhythmic medications that can be used to treat patients with postoperative AF, these arrhythmias were often thought to be benign, producing only transient discomfort, palpitations, or shortness of breath. For patients undergoing cardiac surgery, we now have substantial evidence that postoperative AF is associated with increases in the use of hospital resources, length of hospital stay, and hospital costs. Moreover, postoperative AF has been associated with a variety of other adverse outcomes, including perioperative myocardial infarction, congestive heart failure (CHF), ventricular arrhythmias, renal insufficiency, infection, pneumonia, increased need for inotropic medications, increased use of the intra-aortic balloon pump, prolonged ventilation, increased frequency of reintubation for respiratory distress, increased need for readmission to the intensive care unit, and increased need for tracheostomy. There is a growing recognition that one of the most important clinical consequences of postoperative AF might be an increased incidence of perioperative stroke. We have also come to recognize that these arrhythmias might be persistent or recurrent, even long after discharge from the hospital.

Clinical investigation in adults undergoing cardiac surgery has focused mainly on 2 fronts: (1) the identification of risk factors for . . . [Full Text of this Article]


Related Article

Risk factors associated with atrial fibrillation after noncardiac thoracic surgery: analysis of 2588 patients
Ara A. Vaporciyan, Arlene M. Correa, David C. Rice, Jack A. Roth, W. R. Smythe, Stephen G. Swisher, Garrett L. Walsh, and Joe B. Putnam, Jr
J. Thorac. Cardiovasc. Surg. 2004 127: 779-786. [Abstract] [Full Text] [PDF]





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