INCIDENCE AND SIGNIFICANCE OF CARDIAC-ARRHYTHMIA IN GERIATRIC ORAL-SURGERY PATIENTS

We recorded heart rhythms of 40 older patients (20 medicated for cardi ovascular disease and 20 not medicated for cardiovascular disease) dur ing an outpatient oral surgery visit to determine overall arrhythmia i ncidence and severity, differences in incidence associated with cardio vascular medication status, and the impact of surgical intervention on arrhythmia incidence. We hypothesized that both groups would show sim ilar arrhythmia numbers and types during surgical visits and that a hi story of medication for cardiovascular disease would not be an Indicat or of cardiac arrhythmia. Enrollment remained open until 20 patients o lder than 60 years of age from each group agreed to participate. Data were analyzed using the chi square statistic and Fisher's exact lest ( 2-tailed). Included in the study were 24 women and 16 men; their mean age was 70.5 years (range, 60 to 86 years). Arrhythmias were detected in 17 patients and 33 of the 160 recorded rhythms. None of the detecte d arrhythmias were considered life-threatening. Significantly more arr hythmias occurred before administration of anesthesia than during admi nistration of epinephrine-containing local anesthetics (p = 0.0001), a nd a greater number of rhythm disturbances were seen during the surgic al procedure when compared with anesthesia administration (p = 0.0170) . No differences in arrhythmia incidence were seen with increasing age , when male patients were compared with female patients, or when patie nts pharmacologically treated for cardiovascular disease were compared with patients not taking cardiovascular therapeutic medications. We c onclude that although arrhythmias in this ambulatory population are co mmon, they are typically benign in character and cardiovascular medica tion status is not indicative of their presence. In addition, minor or al surgery intervention with local anesthetics used in recommended dos ages has no effect on cardiac arrhythmia status in the ambulatory geri atric population.