Clinical analysis of perioperative safety and short-term prognosis of non-small cell lung cancer patients with preoperative arrhythmia_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Yunfei ¹ ,  WANG Xiaowen ¹ , LI Linjun ^1,2 , ZHANG Cheng ^1,2 ,  JIANG Yingjiu ¹ , WU Qingchen ¹

1. Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P. R. China;
2. Department of Cardiothoracic Surgery ICU, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P. R. China;

Corresponding?author：

WANG Xiaowen, Email: xiaowenwang@yeah.net; JIANG Yingjiu, Email: jiangyinjiu@yeah.net

Keywords：

Arrhythmia; lung cancer; perioperative period; short-term prognosis

DOI：

10.7507/1007-4848.202109075

Video：

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Objective To analyze the perioperative safety and the short-term prognosis of non-small cell lung cancer (NSCLC) patients with preoperative arrhythmia. Methods The clinical data of NSCLC patients treated in the Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University from August 2020 to March 2021 were collected and observed. The patients were divided into an arrhythmia group and a control group according to whether there was arrhythmia in the 24 h ambulatory electrocardiogram examination report before operation. The incidence of intraoperative and postoperative cardiovascular events and short-term prognosis were compared between the two groups. Results A total of 466 patients were included in this study, including 338 patients in the arrhythmia group, 176 males and 162 females, with a median age of 68.0 (63.0, 72.0) years, and 128 patients in the control group, 59 males and 69 females, with a median age of 66.5 (60.0, 72.0) years. A total of 26 patients (7.7%) in the arrhythmia group were placed with temporary pacemakers before operation. There was no significant difference in the incidence of cardiovascular related events between the two groups [100 (29.6%) vs. 28 (21.9%), P=0.096]. The incidence of postoperative arrhythmia events in the arrhythmia group was higher than that in the control group [112 (33.1%) vs. 11 (8.6%), P<0.001]. The average postoperative ICU stay in the arrhythmia group was longer than that in the control group (1.1±0.7 d vs. 1.0±0.6 d, P=0.039). Conclusion Preoperative arrhythmia does not increase the risk of intraoperative cardiovascular events in NSCLC patients, but increases the incidence of postoperative arrhythmia events and prolongs ICU stay.

Citation： LIU Yunfei, WANG Xiaowen, LI Linjun, ZHANG Cheng, JIANG Yingjiu, WU Qingchen. Clinical analysis of perioperative safety and short-term prognosis of non-small cell lung cancer patients with preoperative arrhythmia. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(8): 1158-1163. doi: 10.7507/1007-4848.202109075 Copy

1.	曾倩, 崔芳芳, 宇傳華, 等. 中國癌癥發病、死亡現狀與趨勢分析. 中國衛生統計, 2016, 33(2): 3.
2.	劉蓓蕾. 腫瘤治療相關心律失常. 心血管病學進展, 2018, 39(2): 4.
3.	Rostagno C, La Meir M, Gelsomino S, et al. Atrial fibrillation after cardiac surgery: Incidence, risk factors, and economic burden. J Cardiothorac Vasc Anesth, 2010, 24(6): 952-958.
4.	岳馨. 非心臟手術術前室性心律失常的臨床特點及不同處理對術后風險影響的研究. 中國醫科大學, 2017.
5.	陳偉, 馮天賜, 王小文, 等. 合并2型糖尿病的非小細胞肺癌患者肺切除術后近期預后的臨床分析. 中國胸心血管外科臨床雜志, 2020, 27(8): 912-917.
6.	張楊楊, 李濤, 錢永軍. 心律失常研究及治療新理念. 中國胸心血管外科臨床雜志, 2019, 26(3): 3.
7.	《中國心臟起搏與心電生理雜志》編輯部, 中國生物醫學工程學會, 心臟起搏與電生理分會. 心臟猝死的防治建議. 中國心臟起搏與心電生理雜志, 2002, 16(6): 401-414.
8.	陳軍. 肺癌術后圍手術期心肺并發癥相關因素的研究. 河北醫科大學, 2014: 1-43.
9.	米麗麗, 董江娜, 王芳, 等. 肺癌患者圍手術期心肺并發癥相關因素研究. 河北醫藥, 2016, 38(15): 2343-2345.
10.	房福元. 194例老年肺癌圍手術期心肺并發癥相關因素的研究. 新疆醫科大學, 2013.
11.	Todorov H, Janssen I, Honndorf S, et al. Clinical significance and risk factors for new onset and recurring atrial fibrillation following cardiac surgery—A retrospective data analysis. BMC Anesthesiol, 2017, 17(1): 163.
12.	Jelena I, Maziak DE, Sarah R, et al. Incidence, severity and perioperative risk factors for atrial fibrillation following pulmonary resection. Interact Cardiovasc Thorac Surg, 2014, 18(3): 340-346.
13.	Annessi V, Paci M, Ricchetti P, et al. Is age over 70 years a risk factor for pneumonectomy. Asian Cardiovasc Thorac Ann, 2009, 17(1): 272-277.
14.	Onaitis M, D'Amico T, Zhao Y, et al. Risk factors for atrial fibrillation after lung cancer surgery: Analysis of the Society of Thoracic Surgeons general thoracic surgery database. Ann Thorac Surg, 2010, 90(2): 368-374.
15.	Farmakis D, Parissis J, Filippatos G. Insights into onco-cardiology: Atrial fibrillation in cancer. J Am Coll Cardiol, 2014, 63(10): 945-953.
16.	張艷麗, 劉瑩, 劉基巍, 等. 腫瘤治療相關性心律失常研究進展. 中華心律失常學雜志, 2017, 21(5): 448-451.
17.	王一北, 陳寬冰, 張洪巖, 等. 肺癌術后房顫危險因素及術后房顫患者的并發癥分析. 貴州醫藥, 2017, 41(8): 835-838.
18.	李雙萍, 劉尚武, 張茂蘭, 等. 肺癌患者心電圖臨床分析與探討. 甘肅醫藥, 2015, 4(5): 321-323.
19.	Klein N, Klein M, Pfeiffer D. Pacemaker, cardiac resynchonisation, implantable cardioverter/defibrillator, event monitoring. Dtsch Med Wochenschr, 2013, 138(49): 2526-2529.
20.	方玉強, 楊成明, 王旭開, 等. 老年患者非心臟手術中臨時起搏器適應證探討. 重慶醫學, 2010, 39(2): 161.
21.	解建, 鄧新桃, 趙建祥, 等. 166例臨時起搏器植入術后并發癥的分析. 中西醫結合心血管病電子雜志, 2018, 6(6): 89-90.
22.	郭曉萍. 經靜脈臨時起搏器術后患者并發癥觀察及體會. 中華醫學會第十五次全國心血管病學大會論文匯編, 2013: 564-565.
23.	王小文, 黃春, 葛明建, 等. 胸腔鏡手術與傳統開胸術后心律失常發生率的前瞻性對比研究. 中華胸心血管外科雜志, 2013, 29(1): 4-7.

1. 曾倩, 崔芳芳, 宇傳華, 等. 中國癌癥發病、死亡現狀與趨勢分析. 中國衛生統計, 2016, 33(2): 3.
2. 劉蓓蕾. 腫瘤治療相關心律失常. 心血管病學進展, 2018, 39(2): 4.
3. Rostagno C, La Meir M, Gelsomino S, et al. Atrial fibrillation after cardiac surgery: Incidence, risk factors, and economic burden. J Cardiothorac Vasc Anesth, 2010, 24(6): 952-958.
4. 岳馨. 非心臟手術術前室性心律失常的臨床特點及不同處理對術后風險影響的研究. 中國醫科大學, 2017.
5. 陳偉, 馮天賜, 王小文, 等. 合并2型糖尿病的非小細胞肺癌患者肺切除術后近期預后的臨床分析. 中國胸心血管外科臨床雜志, 2020, 27(8): 912-917.
6. 張楊楊, 李濤, 錢永軍. 心律失常研究及治療新理念. 中國胸心血管外科臨床雜志, 2019, 26(3): 3.
7. 《中國心臟起搏與心電生理雜志》編輯部, 中國生物醫學工程學會, 心臟起搏與電生理分會. 心臟猝死的防治建議. 中國心臟起搏與心電生理雜志, 2002, 16(6): 401-414.
8. 陳軍. 肺癌術后圍手術期心肺并發癥相關因素的研究. 河北醫科大學, 2014: 1-43.
9. 米麗麗, 董江娜, 王芳, 等. 肺癌患者圍手術期心肺并發癥相關因素研究. 河北醫藥, 2016, 38(15): 2343-2345.
10. 房福元. 194例老年肺癌圍手術期心肺并發癥相關因素的研究. 新疆醫科大學, 2013.
11. Todorov H, Janssen I, Honndorf S, et al. Clinical significance and risk factors for new onset and recurring atrial fibrillation following cardiac surgery—A retrospective data analysis. BMC Anesthesiol, 2017, 17(1): 163.
12. Jelena I, Maziak DE, Sarah R, et al. Incidence, severity and perioperative risk factors for atrial fibrillation following pulmonary resection. Interact Cardiovasc Thorac Surg, 2014, 18(3): 340-346.
13. Annessi V, Paci M, Ricchetti P, et al. Is age over 70 years a risk factor for pneumonectomy. Asian Cardiovasc Thorac Ann, 2009, 17(1): 272-277.
14. Onaitis M, D'Amico T, Zhao Y, et al. Risk factors for atrial fibrillation after lung cancer surgery: Analysis of the Society of Thoracic Surgeons general thoracic surgery database. Ann Thorac Surg, 2010, 90(2): 368-374.
15. Farmakis D, Parissis J, Filippatos G. Insights into onco-cardiology: Atrial fibrillation in cancer. J Am Coll Cardiol, 2014, 63(10): 945-953.
16. 張艷麗, 劉瑩, 劉基巍, 等. 腫瘤治療相關性心律失常研究進展. 中華心律失常學雜志, 2017, 21(5): 448-451.
17. 王一北, 陳寬冰, 張洪巖, 等. 肺癌術后房顫危險因素及術后房顫患者的并發癥分析. 貴州醫藥, 2017, 41(8): 835-838.
18. 李雙萍, 劉尚武, 張茂蘭, 等. 肺癌患者心電圖臨床分析與探討. 甘肅醫藥, 2015, 4(5): 321-323.
19. Klein N, Klein M, Pfeiffer D. Pacemaker, cardiac resynchonisation, implantable cardioverter/defibrillator, event monitoring. Dtsch Med Wochenschr, 2013, 138(49): 2526-2529.
20. 方玉強, 楊成明, 王旭開, 等. 老年患者非心臟手術中臨時起搏器適應證探討. 重慶醫學, 2010, 39(2): 161.
21. 解建, 鄧新桃, 趙建祥, 等. 166例臨時起搏器植入術后并發癥的分析. 中西醫結合心血管病電子雜志, 2018, 6(6): 89-90.
22. 郭曉萍. 經靜脈臨時起搏器術后患者并發癥觀察及體會. 中華醫學會第十五次全國心血管病學大會論文匯編, 2013: 564-565.
23. 王小文, 黃春, 葛明建, 等. 胸腔鏡手術與傳統開胸術后心律失常發生率的前瞻性對比研究. 中華胸心血管外科雜志, 2013, 29(1): 4-7.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical analysis of perioperative safety and short-term prognosis of non-small cell lung cancer patients with preoperative arrhythmia

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