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. 2013 Oct;17(4):680-6.
doi: 10.1093/icvts/ivt238. Epub 2013 Jul 5.

Lower preoperative fluctuation of heart rate variability is an independent risk factor for postoperative atrial fibrillation in patients undergoing major pulmonary resection

Pawel Ciszewski  1 , Joanna Tyczka, Jacek Nadolski, Magdalena Roszak, Wojciech Dyszkiewicz
Affiliations

Lower preoperative fluctuation of heart rate variability is an independent risk factor for postoperative atrial fibrillation in patients undergoing major pulmonary resection

Pawel Ciszewski et al. Interact Cardiovasc Thorac Surg. 2013 Oct.

Abstract

Objectives: The following study presents a special independent atrial fibrillation (AF) risk factor-preoperative fluctuation of heart rate variability (HRV), as well as other perioperative AF risk factors in patients qualified for pneumonectomy and undergoing pneumonectomy or lobectomy for lung cancer.

Methods: The prospective study was performed in patients who had undergone anatomical resection for non-small-cell lung cancer. A total of 117 patients (92 men and 25 women) qualified for statistical research. In order to determine the risk factors, all patients were divided into two groups: Group A-98 patients without AF and Group B-19 patients with AF during the perioperative time. A number of different risk factors of AF have been analysed and further divided into preoperative, operative and postoperative.

Results: Postoperative AF occurred in 19 patients (16%), all of them were male. The patients with higher short-term HRV parameters (SD1, RMSSD), slower mean heart rate and those with a lower fluctuation of HRV-related parameters (HRV Afternoon, Night, Day (A/N/D)) before the operation, were more prone to AF. Postoperative risk of AF was higher in patients with a higher number of ventricular ectopic beats before the operation, a higher number of supraventricular and ventricular ectopic beats and a higher maximal heart rate after the operation. Statistical analysis revealed that male gender and the extent of pulmonary resection, particularly left pneumonectomy, constituted significant risk factors. AF was more often observed in patients who had ASA physical status score of III, in comparison with ASAI and ASAII patients.

Conclusions: Along with other concomitant AF risk factors presented in this work, the evaluation of the fluctuation tendencies of HRV parameters should be taken into consideration before any major lung resection. The balance disturbance between the sympathetic and parasympathetic nervous systems is responsible for AF.

Keywords: Atrial fibrillation risk factors; Heart rate variability; Pulmonary resection.

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Figures

Figure 1:
Figure 1:
Graphical representation of the OR values examined AF risk factors.
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References

    1. Banach M, Kazmierski J, Kowman M, Okonski PK, Sobow T, Kloszewska I, et al. Atrial fibrillation as a nonpsychiatric predictor of delirium after cardiac surgery: a pilot study. Med Sci Monit. 2008;14:286–91. - PubMed
    1. Amar D, Burt M, Reinsel RA, Leung DH. Relationship of early postoperative dysrhythmias and long-term outcome after resection of non-small cell lung cancer. Chest. 1996;110:437–9. doi:10.1378/chest.110.2.437. - DOI - PubMed
    1. Musiał WJ. Udar mozgu i migotanie przedsionkow—niebezpieczny duet. Kard Pol. 2007;65:758–9.
    1. Roselli EE, Murthy SC, Rice TW, Houghtaling PL, Pierce CD, Karchmer DP, et al. Atrial fibrillation complicating lung cancer resection. J Thorac Cardiovasc Surg. 2005;130:438–44. - PubMed
    1. Task Force of The European Society of Cardiology, The North American Society of Pacing, Electrophysiology. Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Eur Heart J. 1996;17:354–87. doi:10.1093/oxfordjournals.eurheartj.a014868. - DOI - PubMed

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