Risk Factors Of Postoperative Arrhythmias After Esophagectomy In Patients With Esophageal Carcinoma

Objective: To identify risk factors associated with the onset of postoperative arrhythmias after esophagectomy. To evaluate the association between postoperative arrhythmias and other postoperative complications.Methods: We reviewed the records of 237 patients who underwent an esophagectomy because of esophageal carcinoma from January, 2004 through December, 2007. Variables such as sex, age, hypertension, coronary heart disease, diabetes, smoking history, preoperative pulmonary function test results (PFTs), left ventricle ejection fraction (EF) results, oral drugs (Calcium channel blockers, Angiotensin converting enzpoe inhibitor, Nitrates, Betaloc, types of operations, anastomotic site, operation time, intraoperative blood loss, pathological types, TNM stages, pre- or post-operative central venous pressure (CVP), hemoglobin, serum potassium level were analyzed as potential risk factors for the occurrence of postoperative arrhythmia. Multivariate logistic test were done to evaluate factors associated with the occurrence of postoperative arrhythmia.Results: The overall incidence of postoperative arrhythmias was 29.1% (n=237). Significant variables associated postoperative arrhythmias were history of coronary heart disease (x~2=9.77, P=0.002), poor PFTs (x~2=7.88, P=0.005), receiving nitrates before operation (x~2= 19.098, P<0.001), three-field esophagectomy (x~2=4.50, P=0.034) and elevated CVP (t=1.99, P=0.049). Supraventricular tachyarrhythmia was associated higher incidence of other severe postoperative complications such as myocardial ischemia, pulmonary complication, anastomotic leakage, stock and death.Conclusion: History of coronary heart disease, poor PFTs, receiving nitrates before operation, three-field esophagectomy, higher postoperative CVP are predictors of postoperative arrhythmias. Supraventricular tachyarrhythmia could be an early indicator of severe postoperative complications.