OBJECTIVE

To study the impact of cardiac arrhythmias in patients with chronic thromboembolic pulmonary hypertension during the early post-operative period.

MATERIALS AND METHODS

During this research, 194 patients with chronic thromboembolic pulmonary hypertension, who underwent pulmonary thromboendarterectomy, were examined. Patients were divided into two groups: the 1^st group — 48 patients with detected cardiac arrhythmias (CAs) in the form of ventricular arrhythmias (VAs) during a cardiopulmonary exercise testing (CPET), the 2^nd group — 146 patients in whom CAs were not registered during CPET.

RESULTS

Patients in the 1^st group had CAs as single and paired ventricular extrasystoles. There was a shorter duration of CPET and a smaller proportion of patients in the 1^st group who reached the anaerobic threshold in addition to significant disruption of pulmonary gas exchange and cardiovascular reactivity compared to the 2^nd group. The early post-operative period in patients of the 1^st group was different from that of patients of the 2^nd group by a higher proportion of patients with the development of acute renal failure and new cases of CAs as well as the longest hospital stay. The revealed VAs during CPET increase the risk of developing CAs in the early post-operative period — OR 3.59 (2.41—6.84; p=0.002) and prolongate the length of hospital stay — OR 2.75 (2.01—4.58; p=0.03).

CONCLUSION

Ventricular arrhythmias in patients with chronic thromboembolic pulmonary hypertension detected during cardiopulmonary exercise testing negatively affect the early post-operative period, increasing the risk of cardiac arrhythmias after surgery and length of hospitalization. The introduction of methods of screening and prevention of cardiac arrhythmias at the stage of preoperative preparation of patients will potentially improve treatment effectiveness and quality of life after surgery.