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Study identifies prevalence, predictors, outcomes of postoperative ventricular arrhythmia
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Patients undergoing cardiac surgery are at higher risk for postoperative ventricular arrhythmia due to four factors: older age, peripheral vascular disease, lower ejection fraction and emergent surgery. Off-pump surgery appears to be protective against postoperative ventricular arrhythmia, according to research in the Journal of the American College of Cardiology.
The retrospective cohort analysis examined associations between postoperative ventricular arrhythmia and long-term outcomes. In total, 14,720 consecutive patients undergoing cardiac surgery at Emory University were culled from the Society of Thoracic Surgeons Adult Care Database from January 2004 to July 2010.
Postoperative ventricular arrhythmia occurred in 1.7% of patients.
According to multivariable analysis, higher incidence of postoperative ventricular arrhythmia was associated with older age (OR=1.018 per 1-year increase in age), peripheral vascular disease (OR=1.41) and emergent surgery (OR=1.77). Lower incidence was linked to higher left ventricular EF (OR=0.97 per 1% increase), off-pump surgery (OR=0.41) and mild chronic obstructive pulmonary disease (OR=0.37).
Patients with postoperative ventricular arrhythmia were also at increased risk for adjusted long-term mortality (HR=2.53) during 3.5 years of follow-up.
In this study, patients with postoperative ventricular arrhythmia were older (mean age, 63 years), had lower LVEF (mean, 43.7) and had greater comorbidities, according to the abstract.
“This study provides the largest analysis to date of the incidence, predictors and outcomes of POVA in patients undergoing heart surgery,” Mikhael F. El-Chami, MD, from the division of cardiology, Emory University, and colleagues wrote in the study.
Disclosure:El-Chami reports receiving a research grant from Medtronic, Inc. All other researchers report no relevant financial disclosures.
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