Predictive Factors of Supraventricular Arrhythmias after Noncardiac Thoracic Surgery: A Multicenter Study


  • Hany M. Elrakhawy
  • Mohamed A. Alassal
  • Nabil Elsadeck
  • Ayman Shaalan
  • Tamer H. Ezeldin
  • Ali Shalabi



Background: Supraventricular cardiac arrhythmias are the most common rhythm disturbances in patients following thoracic surgery. The purpose of our study was to determine which of the clinical parameters are the most valuable in predicting postoperative atrial fibrillation (AF) after lung surgery.

Methods: Retrospective analysis was carried out on 987 patients after noncardiac thoracic surgery to define the prevalence, associated risk factors, and clinical course of postoperative arrhythmias. There were 822 men and 165 women, age 34 to 78 years (mean age: 61 ± 8 years). The patients were divided into two groups depending on the occurrence or absence of supraventricular arrhythmia. Group I consisted of 876 patients who were free from rhythm disturbances. The remaining 111 patients exhibited episodes of supraventricular arrhythmia (29 supraventricular tachycardia; 82 AF). These 111 patients were placed in Group II. Preoperative, operative, and postoperative data were reviewed. Statistical analysis was performed.

Results: A statistically significant difference was found between the two groups in age, previous history of heart disease, and lung resection, especially pneumonectomy. Conclusion: Age, history of prior heart disease, lung resection, and the extent of pulmonary resection are the main risk factors for postoperative supraventricular arrhythmia in patients undergoing major thoracic operations.


Amar D, Burt ME, Bains MS, Leung DHY. 1996. Symptomatic tachydysrhythmias after esophagectomy: incidence and outcome measures. Ann Thorac Surg 61:1506-9.nAmar D, Roistacher N, Rusch VW, et al. 2000. Effects of diltiazem prophylaxis on the incidence and clinical outcome of atrial arrhythmias after thoracic surgery. J Thorac Cardiovasc Surg 120:790-8.nAmar D, Zhang H, Leung DHY, Roistacher N, Kadish AH. 2002. Older age is the strongest predictor of postoperative atrial fibrillation. Anesthesiology 96:352-6.nAnile M, Telha V, Diso D, et al. 2012. Left atrial size predicts the onset of atrial fibrillation after major pulmonary resections. Eur J Cardiothorac Surg 41:1094-7.nAsamura H, Naruke T, Tsuchiya R, Goya T, Kondo H, Suemasu K. 1993. What are the risk factors for arrhythmias after thoracic operations? A retrospective multivariate analysis of 267 consecutive thoracic operations. J Thorac Cardiovasc Surg 106:1104-10.nBobbio A, Caporale D, Internullo E, et al. 2007. Postoperative outcome of patients undergoing lung resection presenting with new-onset atrial fibrillation managed by amiodarone or diltiazem. Eur J Cardiothorac Surg 31:70-4.nCardinale D, Martinoni A, Cipolla CM, et al. 1999. Atrial fibrillation after operation for lung cancer: clinical and prognostic significance. Ann Thorac Surg 68:1827-31.nCiriaco P, Mazzone P, Canneto B, Zannini P. 2000. Supraventricular arrhythmia following lung resection for non-small cell lung cancer and its treatment with amiodarone. Eur J Cardiothorac Surg 18:12-16.nDyszkiewicz W, Skrzypczak M. 1998. Atrial fibrillation after surgery of the lung: clinical analysis of risk factors. Eur J Cardiothorac Surg 13:625-8.nEllenbogen KA, Dias VC, Plumb VJ, Heywood JT, Mirvis DM. 1991. A placebo-controlled trial of continuous intravenous diltiazem infusion for 24-hour heart rate control during atrial fibrillation and atrial flutter: a multicenter study. J Am Coll Cardiol 18:891-7.nGómez-Caro A, Moradiellos FJ, Ausín P, et al. 2006. Risk factors for atrial fibrillation after thoracic surgery. Arch Bronconeumol 42:9-13.nHarpole DH Jr, Liptay MJ, DeCamp MM Jr, Mentzer SJ, Swanson SJ, Sugarbaker DJ. 1996. Prospective analysis of pneumonectomy: risk factors for major morbidity and cardiac dysrhythmias. Ann Thorac Surg 61:977-82.nImperatori A, Mariscalco G, Riganti G, Rotolo N, Conti V, Dominioni L. 2012. Atrial fibrillation after pulmonary lobectomy for lung cancer affects long-term survival in a prospective single-center study. J Cardiothorac Surg 7:4-7.nKrowka MJ, Pairolero PC, Trastek VF, Payne WS, Bernatz PE. 1987. Cardiac dysrhythmia following pneumonectomy: clinical correlates and prognostic significance. Chest 91:490-5.nLanza LA, Visbal AI, DeValeria PA, Zinsmeister AR, Diehl NN, Trastek VF. 2003. Low-dose oral amiodarone prophylaxis reduces atrial fibrillation after pulmonary resection. Ann Thorac Surg 75:223-30.nNeragi-Miandoab S, Weiner S, Sugarbaker DJ. 2008. Incidence of atrial fibrillation after extrapleural pneumonectomy vs. pleurectomy in patients with malignant pleural mesothelioma. Interactive Cardiovasc Thorac Surg 7:1039-43.nOnaitis M, D'Amico T, Zhao Y, O'Brien S, Harpole D. 2010. Risk factors for atrial fibrillation after lung cancer surgery: analysis of the Society of Thoracic Surgeons general thoracic surgery database. Ann Thorac Surg 90:368-74.nPodrid PJ. 1999. Prevention of postoperative atrial fibrillation: What is the best approach? J Am Coll Cardiol 34:340-2.nPolanczyk CA, Goldman L, Marcantonio ER, Orav EJ, Lee TH. 1998. Supraventricular arrhythmia in patients having noncardiac surgery: clinical correlates and effect on length of stay. Ann Intern Med 129:279-85.nRena O, Papalia E, Oliaro A, et al. 2001. Supraventricular arrhythmias after resection surgery of the lung. Eur J Cardiothorac Surg 20:688-93.nSekine Y, Kesler KA, Behnia M, Brooks-Brunn J, Sekine E, Brown JW. 2001. COPD may increase the incidence of refractory supraventricular arrhythmias following pulmonary resection for non-small cell lung cancer. Chest 120:1783-90.nTisdale JE, Wroblewski HA, Wall DS, et al. 2009. A randomized trial evaluating amiodarone for prevention of atrial fibrillation after pulmonary resection. Ann Thorac Surg 88:886-93.nVaporciyan AA, Correa AM, Rice DC, et al. 2004. Risk factors associated with atrial fibrillation after noncardiac thoracic surgery: analysis of 2588 patients. J Thorac Cardiovasc Surg 127:779-86.nVon Knorring J, Lepantalo M, Lindgren L, Lindford O. 1992. Cardiac arrhythmias and myocardial ischemia after thoracotomy for lung cancer. Ann Thorac Surg 53:642-7.nZiomek S, Read RC, Tobler G. 1993. Thromboembolism in patients undergoing thoracotomy. Ann Thorac Surg 56:223-5.n



How to Cite

Elrakhawy, H. M., Alassal, M. A., Elsadeck, N., Shaalan, A., Ezeldin, T. H., & Shalabi, A. (2015). Predictive Factors of Supraventricular Arrhythmias after Noncardiac Thoracic Surgery: A Multicenter Study. The Heart Surgery Forum, 17(6), E308-E312.




Most read articles by the same author(s)