Common Postcardiothoracic Surgery Arrhythmias - 26/07/19

Doi : 10.1016/j.cnc.2019.05.006

Kirstan Clay-Weinfeld, MSN, CRNP, AGACNP-BC, CCRN-CSC-CMC ^a,^⁎ , Melissa Callans, MSN, CRNP, CCDS, FHRS ^a,^b
^a Department of Cardiac Electrophysiology, Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA, USA
^b AGACNP Program, University of Pennsylvania School of Nursing, Philadelphia, 418 Curie Boulevard, Philadelphia, PA 19104, USA

^∗Corresponding author. 800 Spruce Street, Philadelphia, PA 19107.800 Spruce StreetPhiladelphiaPA19107

Résumé

Cardiac arrhythmias are common after cardiac surgery and have profound sequelae. Bradycardias are typically transient and have reversible causes; however, persistent atrioventricular block is an indicator for permanent pacemaker implantation after valvular surgery. Transcatheter aortic valve surgery is associated with even higher rates of permanent pacemaker implantation. Atrial fibrillation, the most common postoperative arrhythmia, is associated with ischemic stroke, myocardial infarction, congestive heart failure, and short-term mortality. Ventricular arrhythmias have extremely high in-hospital mortality, as well as long-term mortality for those who survive the initial event. Implantable cardioverter-defibrillators have been shown to reduce long-term mortality for these patients.

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Keywords : Cardiac surgery, Postoperative arrhythmia, Atrial fibrillation, Coronary artery bypass graft, Valvular surgery, Ventricular tachycardia, Atrioventricular block

Plan

Disclosure Statement: K. Clay-Weinfeld has nothing to disclose. M. Callans has received honoraria for lectures provided by Medtronic in the area of implantable cardiac devices.