[Perioperative cardiac arrhythmias in patients undergoing surgical treatment for lung cancer].

INTRODUCTION Thoracic surgery is associated with a high risk of morbidity and mortality. Cardiac arrhythmias are the most common and severe complications in early postoperative period. OBJECTIVES Evaluation of the prevalence and causes of cardiac arrythmias, factors that predispose to their occurrence and their influence on general state of health in short-term postoperative period. PATIENTS AND METHODS The study was performed in 80 patients with proven primary non-small cell lung cancer. We analyzed demographic data, type of carcinoma, presence of other diseases, laboratory results, and echocardiograms performed 2 times before and after operation and 24-hour Holter monitoring obtained 3 times--a day before thoracotomy and on the 1st and 5th postoperative day. RESULTS There were no significant changes in a total number of supraventricular ectopic beats during 3 consecutive 24-hour Holter recordings. The second Holter recording performed on the 1st postoperative day showed a statistically significant increase (p < 0.05) in the number of ventricular premature beats, which persisted on a similar, higher level on the 5th day. Twenty-four patients (30%) developed atrial fibrillation (AF) in the postoperative period. The average time of the duration of AF was 2.62 days with the peak incidence during 1st and 2nd day after operation (total 62.5%). Apart from cigarette smoking, no other epidemiological and clinical variables affected the occurrence of postoperative AF (p > 0.05). CONCLUSIONS Paroxysmal atrial fibrillation is the most common type of arrhythmias in early postoperative period after thoracic surgery. Patients who underwent thoracic surgery should be under cardiological surveillance during the first postoperative days. Routine prevention with anticoagulants in patients after pulmonary tumor resection should be implemented based on their current clinical condition.