Supraventricular tachyarrhythmia as early indicator of a complicated course after esophagectomy.
In a group of 89 consecutive patients with a standardized operative procedure, the incidence of supraventricular tachyarrhythmia (SVT), predisposing risk factors (preoperative and intraoperative factors and parameters of intensive care strategy) and therapeutic strategies were evaluated. Operative treatment consisted of transthoracic esophagectomy, gastric interposition and intrathoracic anastomosis. Overall hospital mortality was 6.7%. In 32 (37%) patients a new onset SVT occurred. Age and elevated body temperature were the only significant risk factor for SVT in the multivariate analysis, their odds ratios being 1.3 for each year above 58 and 5.6 for each degree above 37.8 degrees C, respectively. Secondary risk factors were history of hypertension and use of epinephrine, the corresponding odds ratios being 6.6 and 10.2. Digitalis (2/32) and calcium-antagonists (2/9) were unsatisfactory, while beta-blockers (13/20) and amiodarone (12/12) were efficient therapeutic agents. Incidence of SVT was significantly correlated with the development of postoperative septic complications.
Stippel
D L
DL
Department of Visceral and Vascular Surgery, University of Cologne, Köln, Germany. Dirk.Stippel@uni-koeln.de
Taylan
C
C
Schröder
W
W
Beckurts
K T E
KT
Hölscher
A H
AH
D000322:Adrenergic Agonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000367:Age Factors; D000638:Amiodarone / Q000627:therapeutic use; D000714:Anastomosis, Surgical; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003422:Critical Care; D004071:Digitalis Glycosides / Q000627:therapeutic use; D004837:Epinephrine / Q000627:therapeutic use; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D005334:Fever / Q000150:complications; D017052:Hospital Mortality; D006801:Humans; D006973:Hypertension / Q000150:complications; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors; D013270:Stomach / Q000601:surgery; D013617:Tachycardia, Supraventricular / Q000209:etiology*
D000322:Adrenergic Agonists; D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D002121:Calcium Channel Blockers; D004071:Digitalis Glycosides; D000638:Amiodarone; D004837:Epinephrine