Abstract
ObjectiveTo compare the incidence of atrial fibrillation (AF) and alteration of heart rate variability (HRV) after pulmonary lobectomy through video assisted thoracic surgery or thoracotomy, and to explore the role of autonomic nerves in the pathogenesis of atrial fibrillation after pulmonary lobectomy.MethodsIn a single institution, 224 patients (age > 60) with normal sinus rhythm were enrolled in the study. Experienced surgeons and anesthetists carried out operation and anesthesia according to the same procedure. The hearts were monitored using Holter for more than 96 h. Any new-onset AF was recorded and HRV was analyzed at different time intervals.ResultsOne hundred twelve patients undergoing video-assisted thoracic surgery (VATS) and 112 patients undergoing thoracotomy (THOR) were matched for age and gender. Atrial fibrillation occurred in 39 patients, with a similar incidence between the two groups (VATS: 19/112, 16.9% and THOR: 20/112, 17.9%, P = 0.82). The post-operational heart variability at different time intervals was comparable between the two groups.ConclusionPulmonary lobectomy through video assisted thoracic surgery does not reduce the postoperative atrial fibrillation. Autonomic nerve mechanism may be involved in the pathogenesis of postoperative atrial fibrillation.
Highlights
Atrial fibrillation (AF) is the most common arrhythmia after noncardiac thoracic surgery, with an incidence of > 20% in elderly people [1]
We found that the postoperatively incidence of AF in non-cardiac thoracic surgery was 20% [6]
Jaklitsch et al reported the incidence of AF as 3.1% in 32 elderly patients undergoing video-assisted thoracic surgery (VATS) lobectomy [7], whereas Gharagozloo et al reported an arrhythmia rate of 9.4% (17/179) [8]
Summary
Atrial fibrillation (AF) is the most common arrhythmia after noncardiac thoracic surgery, with an incidence of > 20% in elderly people [1]. Postoperative AF contributes to increased morbidity and length of hospital stay, as well as greater risk of stroke (in those with persistent AF). The etiology of this complication remains poorly understood. Age of 60 years or older is consistently. He et al Journal of Cardiothoracic Surgery (2020) 15:220 between lobectomy through VATS and thoracotomy. Our study was designed to compare the incidence of AF between VATS and thoracotomy Alteration in postoperative heart variability at different time intervals has been explored
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