Frequency and structure of cardiac arrhythmias in the early postoperative period following cardiac surgery

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
TD Danilevych ◽  
LV Rasputina ◽  
YM Mostovoy ◽  
AV Belinskyi

Abstract 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 <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%).

Author(s):  
A. V. Belinskyi ◽  
L. V. Rasputina ◽  
Y. M. Mostovoy ◽  
O. P. Mostova ◽  
T. D. Danilevych

The occurrence of cognitive disorders is a common problem after surgery. The degree of worsening of cognitive functions after surgery and anesthesia has a significant impact on the patient's health and is significantly associated with prolonged recovery in the hospital, increased morbidity and delayed functional recovery. The aim of the study was to increase the effectiveness of the diagnosis of moderate cognitive impairment and to determine its gender and age characteristics in patients before and after cardiac surgery in the early postoperative period (3 and 7 days). We examined 56 patients who underwent cardiac surgery for coronary heart disease in 37 (66.1 %) and valvular heart defects in 19 (33.9 %) patients. Assessment of cognitive functions was performed before surgery, on the 3rd and 7th day of the postoperative period. Testing was performed using the Montreal Cognitive Test. Statistical processing of the obtained data was performed on a personal computer using the statistical software package SPSS 12.0 for Windows using parametric and non-parametric methods. It was found that presence of cognitive disorders before surgery was registered in 37 (66.1 %) patients, mostly among the age of group of 60-74 years and had no gender difference. It was found that in the early postoperative period there is a significant worsening of cognitive functions in patients after cardiac surgery on 3rd day – in 45 (80.4 %), on 7th day – in 44 (78.6 %) patients, respectively.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
TD Danilevych ◽  
LV Rasputina ◽  
YM Mostovoy ◽  
AV Belinskyi

Abstract Funding Acknowledgements Type of funding sources: None. Background. Identification of high-risk patients and  predictors for cardiac arrhythmias allows the development of preventive measures that will improve the postoperative period and rehabilitation of patients following cardiac surgery. Purpose. To determine probable predictors of arrhythmias in patients following cardiac surgery in the early postoperative period (up to 7 days). Methods. 56 patients were examined, including 19 (33.9%) men (p = 0.02). The average age of the patients was 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 average duration of the operations was 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 vs. 355.47, p = 0.34). Assessment of arrhythmias was performed during the first 7 days after cardiac surgery. Results. 27 (48.2%) patients have developed arrhythmias within first 7 days, among them in 12 (63.2%) women and 15 (40.5%) men (p = 0.24). Predictors of arrhythmias in early postoperative period are: operation with bypass r = 0,332 [1,06-3,03], p = 0,01; the size of left atrium (LA)> 40 mm r =0,296  [1,01-3,31], p = 0,03; presence of coronary artery (CA) stenosis r = 0,139 [1,11-2,69], p = 0,04; atrial fibrillation (AF) in the history r = 0,607  [1,99-5,58], p = 0,001. AF dominates in the structure of arrhythmias – in 17 (30.4%) patients, among them – in 11 (64.7%) was paroxysmal,  6 (35.3%) patients - persistent form. The mean score of CHA2DS2VASc scale - 2.56 ± 0.89. The predictors of AF are: operation with bypass r = 0.451 [1.63-9.76], p= 0.0001; the size of the LA> 40 mm r = 0.303 [1.04-7.58], p = 0.02; left ventricle (LV) ejection fraction (EF) <40% r = -0.207 [1.23-1.82], p = 0.05; mitral regurgitation r = 0.314 [1.05-10.04], p = 0.02. Also registered ventricular ventricular prematute beats (VPB) – in 12 (21.4%) patients, among them VPB 1st Laun class  - in 8 (66.7%), 2nd Laun class – in 2 (16.7%), 3rd Laun class – in 1 (8.3%), 4A Laun class – in 1 (8.3%) patient, respectively. Predictors of VPB are: chronic heart failure (CHF) 4 functional class (FC) r = 0.258 [2.94-8.48,], p = 0.05; CA stenosis r = 0,282 [1,04-40,54], p = 0,04; LV EF <50% r = -0.344 [1,3-9,42], p = 0,009, stroke in the anamnesis r = 0,262 [1,33-9,37], p = 0,05.  Conclusions The prevalence of arrhythmias in the early postoperative period (up to 7 days) following cardiac surgery is 48.2%. The predictors of arrhythmias are: operation with bypass, the size of LA> 40 mm, presence of CA stenosis and any form of AF in the history. AF dominates in the structure of heart arrhythmias (30.4%). The predictors of AF are: operation with bypass, the size of the LA> 40 mm, LV EF <40%, mitral regurgitation according to echocardiography; predictors of VPB are: CHF 4 FC, CA stenosis, LV EF <50%, stroke in the history.


2014 ◽  
Vol 15 (3) ◽  
pp. 276-281 ◽  
Author(s):  
Lurdes Tse ◽  
John B Bowering ◽  
Stephan K W Schwarz ◽  
Randell L Moore ◽  
Richard Sztramko ◽  
...  

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