Risk Factors and Clinical Management of Cardiac Arrhythmias Arising After Lung Cancer Surgery

In the present short review it is attempted to analyze and discuss, along with the appropriate clinical management, the risk factors promoting the emergence of supraventricular cardiac dysrhythmias (SVDs) after lung cancer surgery that may negatively influence the postoperative clinical outcome of these patients. By searching the relevant international literature of the last three decades (from January 1st 1990 to November 30th 2017) 30 out of 101 eligible articles were finally selected on the basis of their title and abstract. The key words which had been used are as follows: Arrhythmias, Cardiac (Mesh), Lung Neoplasms/Surgery (Mesh), Postoperative Complications (Mesh), Postoperative Period (Mesh). The impact of the autonomous nervous system tone, being influenced by the extent of thoracic surgical trauma, on the atria, is of paramount importance regarding the triggering of SVDs. Moreover, it seems that amiodarone constitutes a safe and efficient agent to either protect or restore disturbances of the sinus rhythm resulting from lung cancer surgery. Other medicines such as digitalis, verapamil, diltiazem and beta-blockers, with the exception of amiodarone, should not be administered after thoracic surgery in patients presenting Wolf-Parkinson-White syndrome. Verapamil and diltiazem is contraindicated in patients intravenously receiving beta-blockers or presenting congestive heart failure. The role of cardioversion to restore cardiac arrhythmias after thoracic surgery is also discussed along with the role of anti-coagulation treatment.