Acute Alterations of the Electrocardiogram Following Thoracic Surgery

¹ The Cardiovascular Department, Medical Research Institute, Michael Reese Hospital.

1. Postoperative arrhythmias and pericarditis in 55 patients who underwent thoracic or cardiac surgery have been studied in the electrocardiogram.

2. Auricular fibrillation or flutter were the most common arrhythmias and occurred early after operation. Late onset, more than 10 days after surgery, suggests serious postoperative complications or reactivation of the rheumatic process. Auricular fibrillation develops frequently after surgery for carcinoma of the esophagus and seems to be associated with a grave prognosis.

3. The most important factors in the development of postoperative auricular fibrillation appear to be the age of the patient and preexistent pathology of the atrial myocardium. Hypoxemia and/or vagal irritation may trigger the abnormal mechanism.

4. Surgical pericarditis has an early onset and may follow the usual or an abbreviated electrocardiographic course. An electrocardiographic pattern is described of acute pericarditis modified by digitalis effect, characteristically seen in the first days after mitral commissurotomy.