Clinical analysis of perioperative safety and short-term prognosis of non-small cell lung cancer patients with preoperative arrhythmia_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Yunfei ¹ ,  WANG Xiaowen ¹ , LI Linjun ^1,2 , ZHANG Cheng ^1,2 ,  JIANG Yingjiu ¹ , WU Qingchen ¹

1. Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P. R. China;
2. Department of Cardiothoracic Surgery ICU, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P. R. China;

Corresponding author：

WANG Xiaowen, Email: xiaowenwang@yeah.net; JIANG Yingjiu, Email: jiangyinjiu@yeah.net

Keywords：

Arrhythmia; lung cancer; perioperative period; short-term prognosis

DOI：

10.7507/1007-4848.202109075

Video：

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Objective To analyze the perioperative safety and the short-term prognosis of non-small cell lung cancer (NSCLC) patients with preoperative arrhythmia. Methods The clinical data of NSCLC patients treated in the Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University from August 2020 to March 2021 were collected and observed. The patients were divided into an arrhythmia group and a control group according to whether there was arrhythmia in the 24 h ambulatory electrocardiogram examination report before operation. The incidence of intraoperative and postoperative cardiovascular events and short-term prognosis were compared between the two groups. Results A total of 466 patients were included in this study, including 338 patients in the arrhythmia group, 176 males and 162 females, with a median age of 68.0 (63.0, 72.0) years, and 128 patients in the control group, 59 males and 69 females, with a median age of 66.5 (60.0, 72.0) years. A total of 26 patients (7.7%) in the arrhythmia group were placed with temporary pacemakers before operation. There was no significant difference in the incidence of cardiovascular related events between the two groups [100 (29.6%) vs. 28 (21.9%), P=0.096]. The incidence of postoperative arrhythmia events in the arrhythmia group was higher than that in the control group [112 (33.1%) vs. 11 (8.6%), P<0.001]. The average postoperative ICU stay in the arrhythmia group was longer than that in the control group (1.1±0.7 d vs. 1.0±0.6 d, P=0.039). Conclusion Preoperative arrhythmia does not increase the risk of intraoperative cardiovascular events in NSCLC patients, but increases the incidence of postoperative arrhythmia events and prolongs ICU stay.

Citation： LIU Yunfei, WANG Xiaowen, LI Linjun, ZHANG Cheng, JIANG Yingjiu, WU Qingchen. Clinical analysis of perioperative safety and short-term prognosis of non-small cell lung cancer patients with preoperative arrhythmia. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(8): 1158-1163. doi: 10.7507/1007-4848.202109075 Copy

1.	曾倩, 崔芳芳, 宇传华, 等. 中国癌症发病、死亡现状与趋势分析. 中国卫生统计, 2016, 33(2): 3.
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5.	陈伟, 冯天赐, 王小文, 等. 合并2型糖尿病的非小细胞肺癌患者肺切除术后近期预后的临床分析. 中国胸心血管外科临床杂志, 2020, 27(8): 912-917.
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22.	郭晓萍. 经静脉临时起搏器术后患者并发症观察及体会. 中华医学会第十五次全国心血管病学大会论文汇编, 2013: 564-565.
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1. 曾倩, 崔芳芳, 宇传华, 等. 中国癌症发病、死亡现状与趋势分析. 中国卫生统计, 2016, 33(2): 3.
2. 刘蓓蕾. 肿瘤治疗相关心律失常. 心血管病学进展, 2018, 39(2): 4.
3. Rostagno C, La Meir M, Gelsomino S, et al. Atrial fibrillation after cardiac surgery: Incidence, risk factors, and economic burden. J Cardiothorac Vasc Anesth, 2010, 24(6): 952-958.
4. 岳馨. 非心脏手术术前室性心律失常的临床特点及不同处理对术后风险影响的研究. 中国医科大学, 2017.
5. 陈伟, 冯天赐, 王小文, 等. 合并2型糖尿病的非小细胞肺癌患者肺切除术后近期预后的临床分析. 中国胸心血管外科临床杂志, 2020, 27(8): 912-917.
6. 张杨杨, 李涛, 钱永军. 心律失常研究及治疗新理念. 中国胸心血管外科临床杂志, 2019, 26(3): 3.
7. 《中国心脏起搏与心电生理杂志》编辑部, 中国生物医学工程学会, 心脏起搏与电生理分会. 心脏猝死的防治建议. 中国心脏起搏与心电生理杂志, 2002, 16(6): 401-414.
8. 陈军. 肺癌术后围手术期心肺并发症相关因素的研究. 河北医科大学, 2014: 1-43.
9. 米丽丽, 董江娜, 王芳, 等. 肺癌患者围手术期心肺并发症相关因素研究. 河北医药, 2016, 38(15): 2343-2345.
10. 房福元. 194例老年肺癌围手术期心肺并发症相关因素的研究. 新疆医科大学, 2013.
11. Todorov H, Janssen I, Honndorf S, et al. Clinical significance and risk factors for new onset and recurring atrial fibrillation following cardiac surgery—A retrospective data analysis. BMC Anesthesiol, 2017, 17(1): 163.
12. Jelena I, Maziak DE, Sarah R, et al. Incidence, severity and perioperative risk factors for atrial fibrillation following pulmonary resection. Interact Cardiovasc Thorac Surg, 2014, 18(3): 340-346.
13. Annessi V, Paci M, Ricchetti P, et al. Is age over 70 years a risk factor for pneumonectomy. Asian Cardiovasc Thorac Ann, 2009, 17(1): 272-277.
14. Onaitis M, D'Amico T, Zhao Y, et al. Risk factors for atrial fibrillation after lung cancer surgery: Analysis of the Society of Thoracic Surgeons general thoracic surgery database. Ann Thorac Surg, 2010, 90(2): 368-374.
15. Farmakis D, Parissis J, Filippatos G. Insights into onco-cardiology: Atrial fibrillation in cancer. J Am Coll Cardiol, 2014, 63(10): 945-953.
16. 张艳丽, 刘莹, 刘基巍, 等. 肿瘤治疗相关性心律失常研究进展. 中华心律失常学杂志, 2017, 21(5): 448-451.
17. 王一北, 陈宽冰, 张洪岩, 等. 肺癌术后房颤危险因素及术后房颤患者的并发症分析. 贵州医药, 2017, 41(8): 835-838.
18. 李双萍, 刘尚武, 张茂兰, 等. 肺癌患者心电图临床分析与探讨. 甘肃医药, 2015, 4(5): 321-323.
19. Klein N, Klein M, Pfeiffer D. Pacemaker, cardiac resynchonisation, implantable cardioverter/defibrillator, event monitoring. Dtsch Med Wochenschr, 2013, 138(49): 2526-2529.
20. 方玉强, 杨成明, 王旭开, 等. 老年患者非心脏手术中临时起搏器适应证探讨. 重庆医学, 2010, 39(2): 161.
21. 解建, 邓新桃, 赵建祥, 等. 166例临时起搏器植入术后并发症的分析. 中西医结合心血管病电子杂志, 2018, 6(6): 89-90.
22. 郭晓萍. 经静脉临时起搏器术后患者并发症观察及体会. 中华医学会第十五次全国心血管病学大会论文汇编, 2013: 564-565.
23. 王小文, 黄春, 葛明建, 等. 胸腔镜手术与传统开胸术后心律失常发生率的前瞻性对比研究. 中华胸心血管外科杂志, 2013, 29(1): 4-7.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical analysis of perioperative safety and short-term prognosis of non-small cell lung cancer patients with preoperative arrhythmia

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