Incidence and risk factors associated with cardiac arrhythmias during rehabilitation after coronary artery bypass surgery

Objective: To evaluate the clinical relevance of cardiac arrhythmias during rehabilitation after coronary artery bypass graft (CABG) surgery. Design: Survey of consecutive patients admitted to an inpatient cardiac reh abilitation center. Setting: A rehabilitation center acting as a reference for cardiology clini cs lacking this facility. The program was performed in the inpatient settin g. Patients: Two hundred sixty patients undergoing elective CABG surgery for a ngina. Interventions: Four-week cardiac rehabilitation program. A 24-hour electroc ardiographic examination was performed during the first 2 days and, subsequ ently, on a daily basis. Main Outcome Measures: Incidence and type of cardiac arrhythmias during reh abilitation; identification of factors associated with an increased risk of cardiac arrhythmias. Results: Cardiac arrhythmias were recorded in 33.5% of the patients and wer e more frequent in patients with hypertension (47%), diabetes (42.4%), and hyperlipidemia (36.5%), compared with patients free from these diseases (15 .5%) (p < .05). Arrhythmias were also recorded in patients older than 70 ye ars (49%), compared with those younger (29.2%) (p < .01), and in patients w ho discontinued amiodarone (64.3%) compared with those who did not interrup t the drug (16%) (p < .005). Arrhythmias precluded rehabilitation in 5% of the patients and caused death in one patient. Conclusion: Surveillance for the development of cardiac arrhythmias during cardiac rehabilitation after CABG surgery may allow the early detection and treatment of arrhythmias in a substantial number of patients.