Supraventricular tachyarrhythmias in hospitalized adults after surgery. Clinical correlates in patients over 40 years of age after major noncardiac surgery

Abstract

To assess the clinical correlates and therapeutic outcome of new postoperative supraventricular tachyarrhythmias, 916 patients who were in sinus rhythm throughout the course of surgery were prospectively followed after major noncardiac surgery. The 35 patients (4 percent) who developed new postoperative supraventricular tachyarrhythmias frequently had concurrent medical problems, such as the following: other acute cardiac conditions, 16 patients (46 percent); major infections, 11 patients (31 percent); preexisting hypotension, ten patients (29 percent); anemia, nine patients (26 percent); metabolic derangements, eight patients (23 percent); parenteral therapy with new medications, eight patients (23 percent); and hypoxia, seven patients (20 percent). The arrhythmias of all treated patients reverted to sinus rhythm; 40 percent (14 patients) required no new therapy with cardiac medications, and only two patients required electrical cardioversion. No deaths were related to the supraventricular tachyarrhythmias, but 49 percent (17) of the patients died from their concurrent medical problems. The onset of a new postoperative supraventricular tachyarrhythmia should prompt a search for remediable medical problems. Direct antiarrhythmic therapy is often unnecessary and is usually secondary in importance to correction of the causes of the arrhythmia.