Postoperative Cardiac Rhythm Disturbances in Elders

Question 1

Postoperative cardiac rhythm disturbances are of concern b/c they can cause ______ischemia and/or heart _____.

Answer 1

1. Myocardial ischemia

2. Heart failure

Question 2

SVT, common in older patients, is associated with ____SVT, _____, heart____, and PACs on the _____ ECG.

Answer 2

1. previous episodes of SVT
2. asthma
3. heart failure
4. PACs on the preoperative ECG

Question 3

SVT is more common in patients who have had which 3 kinds of surgical procedures?

Answer 3

1. Vascular
2. abdominal
3. Thoracic

Question 4

Name three different types of IV infusions which may be used to control (or convert to sinus rhythm)postoperative SVT.

Answer 4

1. adenosine
2. IV beta-blocker
3. IV Calcium channel blocker

Question 5

If postoperative atrial fibrillation is poorly tolerated, and the risk of thromboembolism is low, one may attempt to convert Afib to sinus rhythm with _______ or ____ _____.

Answer 5

1. IV amiodarone

2. Electrical cardioversion

Question 6

Because postoperative Afib often spontaneously converts back to sinus rhythm within 6 weeks after surgery, reconsider whether long-term __________ therapy is really needed.

Answer 6

anti-arrhythmic medication (such as amiodarone)

Question 7

If postoperative Afib persists beyond 24 to 48hrs, considerations should be given to using ____________therapy to prevent stroke.

Answer 7

Anticoagulation

Question 8

Postoperative heart failure can be caused by 1.____, 2._____, 3.______.

Answer 8

1. new cardiac ischemia
2. Rhythm disturbance
3. excessive fluid administration

Question 9

Has the use of pulmonary artery catheters to assess filling pressures post-operatively been beneficial in management or prevention of post-op heart failure? What is the Strength of Evidence against using this modality?

Answer 9

1. No benefit in reducing mortality has consistently been demonstrated.
2. SOE=C against using pulmonary artery catheters

Question 10

Most older adults undergoing surgery should receive prophylaxis to prevent 1.______ and 2.________.

Answer 10

1. Deep vein thrombosis

2. Pulmonary embolism