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Perioperative arrhythmias may be linked with sudden death

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2010 Vascular Annual Meeting

Asymptomatic perioperative arrhythmias were associated with sudden cardiac death, new study findings indicated.

Researchers from Netherlands reviewed data from 483 patients undergoing vascular surgery without a history of cardiac arrhythmias, noting preoperative cardiac risk factors, left ventricular function, medical therapy and perioperative ischemia.

“New-onset perioperative ventricular tachyarrhythmia (VT), defined as sustained VT, was detected in 33 (7%) patients,” said Tamara Winkel, MD, a research fellow from the vascular surgery department of the Erasmus Medical Center in Rotterdam, in a press release. “Patients with perioperative VT had a significantly reduced LV function and were undertreated with statins.”

Researchers also noted VT patients had an increased incidence of myocardial ischemia (30%) vs. patients without VT (18%). During a two year median follow-up, cardiac death occurred in 56 patients, 48 of which were classified as sudden death. Seven patients (21%) with perioperative VT died due to sudden cardiac death within three years of vascular surgery. Following adjustment for risk factors, new-onset perioperative VT was associated with sudden cardiac death (HR=2.3; 95% CI, 1.2-5.7).

“Longer continuous implanted cardiac monitors could detect these perioperative episodes of arrhythmia which in turn could have important therapeutic and prognostic consequences,” Winkel said. "In theory, preemptive ICD implantation would benefit high-risk surgery patients and it is now important that more research be done in the future to support that.”

For more information:

• Winkel T. Abstract SS33 Presented at: 2010 Vascular Annual Meeting; June 10-13, 2010; Boston.

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