Arrhythmias following cardiac valve replacement

• Published in: Circulation (New York, N.Y.) N.Y.), 1972-05, Vol.45 (5), p.1018-1023
• Main Authors: Smith, R, Grossman, W, Johnson, L, Segal, H, Collins, J, Dalen, J
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aortic Valve; Arrhythmias, Cardiac - epidemiology; Arrhythmias, Cardiac - etiology; Arrhythmias, Cardiac - mortality; Atrial Fibrillation - etiology; Atrial Flutter - etiology; Blood Urea Nitrogen; Digoxin - therapeutic use; Female; Heart Block - etiology; Heart Valve Prosthesis - adverse effects; Humans; Male; Middle Aged; Mitral Valve; Prospective Studies; Tachycardia, Paroxysmal - etiology; Tricuspid Valve; Ventricular Fibrillation - etiology
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.45.5.1018

A prospective study of 50 consecutive patients undergoing cardiac valve replacement was designed to determine the incidence, types, and predisposing factors to postoperative arrhythmias. Patients were monitored continuously for the first 7 days following surgery. Thirty-seven patients (74%) experienced a total of 66 episodes of arrhythmia. Supra-ventricualr arrhythmias were the most common (43 of 66; 65%). The most frequent specific arrhythmia was atrial fibrillation (21 of 66; 32%). Arrhythmias occurred 77% of the time within the first 48 hours of surgery. Of 25 factors evaluated preoperatively in each patient, only two were found to predispose to postoperative arrhythmias. These were: (1) previous cardiac surgery; and (2) elevated blood urea nitrogen. There were four hospital deaths, representinig a hospital mortality of 8%. No deaths were due to a primary arrhythmia. It is concluded that whereas arrhythmias are a very common complication of cardiac valve replacement, early detection and treatment has lessened their significance as a cause of postoperative mortality and morbidity.