Saran, Tajinder (2010) Arrhythmias in patients undergoing thoracotomies. MD thesis, University of Warwick.

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Abstract

The aims of the thesis are to elucidate the incidence of post-operative supraventricular
arrhythmias (SVA) in patients that undergo thoracotomy for lung or
oesophageal resection in the local population and to determine risk factors
associated with the development of SVA. Further objectives are to compare
methods of SVA detection and to prospectively evaluate the role of magnesium
sulphate as a preventative measure.
The incidence of post-thoracotomy SVA in the local population was 25.5% which
was found to be higher than reports in the literature. Yield of arrhythmia
detection did not differ between continuous electrocardiogram monitoring and 12
lead electrocardiogram recordings.
Risk factors identified were increasing age, the presence of ischaemic heart
disease and hypertension, and undergoing a pneumonectomy. There was a
trend towards a higher mortality in the group that developed an arrhythmia, in
the pilot study. The amount of lung resected was also found to be significantly
associated with an increasing incidence of SVA post-operatively.
The prophylactic, peri-operative administration of intravenous magnesium
sulphate did not reduce the incidence of SVA post-thoracotomy overall. The
peripheral administration of magnesium sulphate was not well tolerated
secondary to the minor side effect of stinging, although no major side effects
such as respiratory depression were observed. However, it did significantly
reduce the incidence of SVA in the higher risk cohort pneumonectomy subgroup.
Further work is anticipated in this group along with further research into
risk factors and aetiology.

Item Type:	Thesis or Dissertation (MD)
Subjects:	R Medicine > RC Internal medicine R Medicine > RD Surgery
Library of Congress Subject Headings (LCSH):	Arrhythmia, Chest -- Surgery -- Complications, Magnesium sulfate -- Physiological effect
Official Date:	January 2010
Dates:	Date Event January 2010 Submitted
Institution:	University of Warwick
Theses Department:	Warwick Medical School
Thesis Type:	MD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Perkins, Gavin D. ; Smith, F. Gao (Fang Gao)
Sponsors:	Heart of England NHS Foundation Trust ; British Heart Foundation ; European Association of Cardiothoracic Anaesthesiologists
Extent:	216 leaves : ill., charts
Language:	eng
URI:	http://wrap.warwick.ac.uk/id/eprint/3925

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