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[Postoperative arrhythmias in heart surgery].

F Coraim, S Duma, F Helmer

    Acta Medica Austriaca
    |January 1, 1982
    PubMed
    Summary

    Postoperative cardiac arrhythmias after open heart surgery can be treated with metabolic therapy. Administering insulin, potassium, and glucose improves energy metabolism, reduces arrhythmias, and promotes normal heart rhythm.

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    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Intensive Care Medicine

    Context:

    • Postoperative cardiac arrhythmias are a common complication following open heart surgery.
    • The use of cardiopulmonary bypass (heart-lung machine) can lead to metabolic disturbances.
    • These disturbances resemble the shock phase seen after myocardial infarction.

    Purpose:

    • To discuss the therapeutic options for postoperative cardiac arrhythmias.
    • To highlight the potential of metabolic therapy as a treatment modality.
    • To explain the underlying mechanisms of metabolic derangements contributing to arrhythmias.

    Summary:

    • Postoperative cardiac arrhythmias are primarily treated with antiarrhythmic drugs, cardioversion, or pacing.
    • Metabolic therapy, involving high-dose insulin and potassium with glucose infusion, is presented as an alternative.

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  • This therapy addresses disordered energy metabolism, impaired insulin effectiveness, and diminished intracellular potassium shifting, which compromise myocardial cell membrane potential.

    • Impact:

    • Metabolic therapy improves intracellular potassium shifting and lowers free fatty acid (FFA) levels.
    • This approach reduces the incidence of cardiac arrhythmias.
    • It aids in the induction and maintenance of normal sinus rhythm post-surgery.