Cardiac arrhythmias post-esophagectomy as the second day complication

Introduction

We observed by the second day, cardiac arrhythmias in most of the patients undergo to esophagectomy. The main anomalies were ventricular arrhythmias with and without haemodynamic dysfunction.

We tried to find a relationship between those arrhythmias and the electrolyte variations in the first 48 h after the operation.

Materials and methods

A retrospective study was performed in 28 patients admitted after esophageal surgery, during a 2 year period. Data collected for all patients included age, SAPSII, and the occurrence of acute arrhythmias. In all patients was analysed blood levels of calcium, phosphorus, magnesium, potassium and pH. The patients were divided in two groups: A, with `malign' ventricular arrhythmias; B, without arrhythmias. We compared and analysed the outside of the normal range (referrable laboratorial values at our institution) for the blood. Data are reported as mean and standard deviation.

Results

See table.

Conclusion

It is well known that post-operative electrolyte and water metabolism imbalance is a common cause of cardiac rhythm disturbances. In this study we were able to verify that patients with cardiac rhythm disturbance had the lowest median blood levels of calcium and phosphorus on admission at the ICU. Twenty-four hours after the admission the same ions still remain at low blood levels. Concerning the other ions, there was no differences between the two groups, and the values were in the normal range. However, present data do not permit to establish a strong causal relationship between this rhythm disturbance and the electrolyte imbalance, because some patients of the lowest ion levels (group A) exhibit normal levels after surgery. We think, therefore, that further investigation is needed to understand the cardiac rhythm disturbance at the second day after esophagectomy.

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