Evaluating Early Asymptomatic Postoperative Sinus Bradycardia Following Sleeve Gastrectomy: A Preliminary...

Postoperative bradycardia, particularly in the early postoperative phase, is a potential complication following bariatric surgeries such as sleeve gastrectomy (SG). While various types of bradycardias have been documented as complications, early-onset sinus bradycardia has received limited attention. This case series specifically investigates the incidence and progression of early postoperative sinus bradycardia in patients undergoing laparoscopic SG, excluding those with hiatal hernias or cardiovascular comorbidities.

We conducted a retrospective series of patients aged 18 to 50 years with morbid obesity (BMI ≥ 35 kg/m2) who underwent laparoscopic SG from January 2016 to March 2023. All patients were monitored for postoperative bradycardia, defined as heart rates below 60 beats per minute (bpm), and were evaluated with electrocardiograms (ECG) and echocardiograms (ECHO). Data were analyzed using descriptive statistics and R software version 4.3.1.

The study included eight patients with a mean age of 34.88 ± 9.05 years and a mean BMI of 44.25 ± 3.62. Postoperative heart rates showed an initial increase to 79.6 ± 4.8 bpm, followed by a gradual decline, reaching 50 ± 3.17 bpm by discharge. Heart rates dropped significantly after 12 h, stabilizing by 24 h. The mean time to return to normal heart rate was 14 ± 4.36 days. All patients had routine preoperative ECG and ECHO, and no significant cardiac abnormalities were noted postoperatively.

This case series underscores the occurrence of early postoperative sinus bradycardia in SG patients, a phenomenon that is underexplored in the literature. Future studies should investigate the pathophysiology of this condition and evaluate its clinical implications for postoperative care.