[Postoperative arrhythmias in heart surgery]

After a brief comment on the origin and a summing up of types of postoperative cardiac arrhythmias in open heart surgery, mainly the therapy of these arrhythmias is discussed Besides drug therapy (antiarrhythmica) and cardioversion resp. pacing especially the possibility of a metabolic therapy is presented. In the postoperative phase after the trauma by the operation with the heart lung machine - which is similar to the shock phase after a myocardial infarction - a disordered energy metabolism with a decreased effectiveness of insulin occurs. It exists a diminished intracellular potassium-shifting, which causes an insufficient myocardial cell membrane potential. By means of exogenous high insulin and potassium supply with glucose infusion the potassium-shifting is improved, the FFA-level is lowered and the incidence of arrhythmias is reduced as sinusrhythm is induced.