SUPRAVENTRICULAR TACHYARRHYTHMIAS DURING TOTAL JOINT ARTHROPLASTY - INCIDENCE AND RISK

Perioperative supraventricular tachyarrhythmias (AF/SVT) have been lon g recognized as a complication after major surgery, but little is know n about the incidence after major nonthoracic surgery. One thousand tw o hundred ten consecutive patients undergoing total hip or knee arthro plasty were studied to determine the incidence of new onset AF/SVT. In formation on preoperative medical history and laboratory tests were co llected in a subset of 583 patients, and analyzed using logistic regre ssion and linear analysis to determine risk. Ninety-four-and-one-half percent of patients received an epidural anesthetic, 4.1% had general anesthesia and 1.3% had spinal anesthesia. New onset AF/SVT was found in 38 of 1210 patients, representing an incidence of 3.1%. In the subs et of 583 patients, the incidence was 4.8%. The only variables found t o be independently associated with the perioperative development of AF /SVT were a history of atrial fibrillation, increasing age, left anter ior hemi-block, and atrial premature depolarizations on the preoperati ve electrocardiogram. In those patients 60 years of age or older with one or more positive risk factors (13% of the study population), the i ncidence was 18.2%. In those patients less than 60 years of age with n one of the identified risks, the incidence was 1.9%.