Perioperative arrhythmia prophylaxis for major lung resection

Perioperative arrhythmia is one of the most common complications following general thoracic surgery. The most common types are atrial fibrillation, supraventricular tachycardia, atrial flutter and premature ventricular contractions. Sustained ventricular tachyarrhythmias are very rare after thoracic surgery and will not be discussed in this chapter. The reported incidence of postoperative supraventricular arrhythmias ranges between 4-33%, and onset typically peaks within the first 3 postoperative days.¹ Although considered by some a minor, self-limited event, perioperative arrhythmia has been shown in recent studies to be associated with greater numbers of complications, longer hospital stays, and increased overall hospital costs.^2-7 Furthermore, when arrhythmias persist or are recurrent, the risk of thromboembolic events, including stroke or transient neurological injury, increases. This warrants anticoagulation that can lead to bleeding complications and increased healthcare expenditures.