THE QT INTERVAL FOLLOWING CAROTID-ARTERY RESECTION

Background. Right radical neck dissection has been shown to prolong th e QT interval, reportedly caused by surgical trauma to the cervical au tonomic system, which may result in malignant ventricular arrhythmias. Carotid artery resection would be expected to be more likely to cause dangerous arrhythmias. Methods. We prospectively studied eight patien ts with electrocardiograms before and after carotid resection. Four pa tients had left-sided procedures and four patients had right-sided pro cedures. In addition, 11 patients were studied retrospectively. QT int ervals were normal in all patients preoperatively. Results. Preoperati ve corrected QT intervals (QTc) were in the normal range used by our i nstitution for all eight patients in the prospective group. There were no significant QTc changes after either left-sided or right-sided car otid resection. However, the retrospective group did show significant changes in QTc following right carotid resection (n = 5), but not left resection (n = 6). Conclusions. EKG changes associated with carotid r esection may not be uniform and may depend on surgical technique or sp ecific anatomic factors. Controlled prospective studies are needed to confirm the prevalence of QT interval changes in radical neck surgery. (C) 1995 John Wiley and Sons, Inc.