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Multicenter Study
. 2016 Apr;151(4):982-8.
doi: 10.1016/j.jtcvs.2015.11.057. Epub 2015 Dec 12.

Incidence and implications of postoperative supraventricular tachycardia after pulmonary lobectomy

Gregory P Giambrone  1 , Xian Wu  2 , Licia K Gaber-Baylis  1 , Akshay U Bhat  3 , Ramin Zabih  3 , Nasser K Altorki  4 , Peter M Fleischut  1 , Brendon M Stiles  5
Affiliations
Multicenter Study

Incidence and implications of postoperative supraventricular tachycardia after pulmonary lobectomy

Gregory P Giambrone et al. J Thorac Cardiovasc Surg. 2016 Apr.

Abstract

Objective: We sought to determine the rate of postoperative supraventricular tachycardia (POSVT) in patients undergoing pulmonary lobectomy, and its association with adverse outcomes.

Methods: Using the State Inpatient Database, from the Healthcare Cost and Utilization Project, we reviewed lobectomies performed (2009-2011) in California, Florida, and New York, to determine POSVT incidence. Patients were grouped by presence or absence of POSVT, with or without other complications. Stroke rates were analyzed independently from other complications. Multivariable regression analysis was used to determine factors associated with POSVT.

Results: Among 20,695 lobectomies performed, 2449 (11.8%) patients had POSVT, including 1116 (5.4%) with isolated POSVT and 1333 (6.4%) with POSVT with other complications. Clinical predictors of POSVT included age ≥75 years, male gender, white race, chronic obstructive pulmonary disease, congestive heart failure, thoracotomy surgical approach, and pulmonary complications. POSVT was associated with an increase of: stroke (odds ratio [OR] 1.74; 95% confidence interval [CI] 1.03-2.94); in-hospital death (OR 1.85; 95% CI 1.45-2.35); LOS (OR 1.33; 95% CI 1.29-1.37); and readmission (OR 1.29; 95% CI 1.04-1.60). The stroke rate was <1% in patients who had isolated POSVT, and 1.5% in patients with POSVT with other complications. Patients with isolated POSVT had increased readmission and LOS, and a marginal increase in stroke rate, compared with patients with an uncomplicated course.

Conclusions: POSVT is common in patients undergoing pulmonary lobectomy and is associated with adverse outcomes. Comparative studies are needed to determine whether strict adherence to recently published guidelines will decrease the rate of stroke, readmission, and death after POSVT in thoracic surgical patients.

Keywords: postoperative supraventricular tachycardia; pulmonary lobectomy.

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Conflict of interest statement

Co-Authors Bhat, Zabih, and Fleischut have a financial interest in the company, Analytical Care. No conflict of interest exists with the current manuscripts.

Figures

Figure 1
Figure 1
Association between postoperative supraventricular tachycardia and adverse outcomes following pulmonary lobectomy. Odds ratios (circles) and confidence intervals are presented for post-operative stroke (p=0.04), in-hospital death (p<0.001), length of stay (p<0.001), and 30-day readmission (p=0.02).
See this image and copyright information in PMC

Comment in

  • Postoperative atrial fibrillation: Is there a need for prevention?
    Amar D. Amar D. J Thorac Cardiovasc Surg. 2016 Apr;151(4):913-5. doi: 10.1016/j.jtcvs.2015.09.041. Epub 2015 Sep 18. J Thorac Cardiovasc Surg. 2016. PMID: 26478239 No abstract available.
  • Postoperative atrial arrhythmias: Where do we go from here?
    Fernandez FG. Fernandez FG. J Thorac Cardiovasc Surg. 2016 Apr;151(4):990-1. doi: 10.1016/j.jtcvs.2015.12.012. Epub 2015 Dec 13. J Thorac Cardiovasc Surg. 2016. PMID: 26778377 No abstract available.
  • Discussion.
    [No authors listed] [No authors listed] J Thorac Cardiovasc Surg. 2016 Apr;151(4):988-9. doi: 10.1016/j.jtcvs.2015.11.061. Epub 2016 Jan 14. J Thorac Cardiovasc Surg. 2016. PMID: 26778382 No abstract available.

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