Post operative cardiac arrhythmias

Post operative cardiac arrhythmias Post operative cardiac arrhythmias are a major cause of morbidity and mortality, more so following surgery for congenital heart disease. Tolerability of arrhythmia is less in the postoperative period than for similar arrhythmia in the preoperative period. Hemodynamic instability is more likely due to the possibility of myocardial dysfunction. Cardiopulmonary bypass, injury to the conduction system during surgery, metabolic and electrolyte abnormalities, especially hypokalemia and hypomagnesemia contribute to the increased incidence of postoperative arrhythmias. Stress of the surgery with enhanced sympathetic tone and use of inotropic support are added factors. Delayed arrhythmia can occur due to scar related re-entry. Atrial fibrillation is one of the commonest arrhythmias after coronary artery bypass surgery. Peri operative use of beta blockers have a role in reducing the incidence of postoperative atrial fibrillation. The earlier you resume beta blockers after surgery the better. A note of caution about beta blockers is needed in those with bradycardia and ventricular dysfunction. Junctional ectopic tachycardia (JET) is a unique postoperative arrhythmia, especially in children after cardiac surgery. JET is often difficult to treat. It is likely to recur after cardioversion. Sedation and cooling (hypothermia) are helpful. It is always better to take a 12 lead ECG for evaluation of postoperative cardiac arrhythmia rather than taking a decisi...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiac Surgery ECG / Electrophysiology Source Type: blogs