DOI: 10.25881/BPNMSC.2020.37.58.017

Authors

Goncharov M.A.

Pirogov National Medical and Surgical Center, Moscow

Abstract

The article considers the main problems that arise when assessing the risk of developing cardiovascular complications during planned non-cardiac surgical interventions and in the postoperative period at patients with cardiac arrhythmias and conduction. The author describes heart rhythm disturbances that require a temporary cancellation of a planned non-cardiac surgical intervention. The article also proposes variants of risk stratification according to specially developed scales and determination of the required volume of preoperative examination.

Keywords: noncardiac surgery, ventricular extrasystoles, supraventricular extrasystoles, Wolff-Parkinson-White syndrome, bradyarrhythmias, atrioventricular block, sinus node dysfunction, atrial fibrillation, atrial flutter.

References

1. Belyalov FI. Aritmii serdtsa. 7nd ed., revised and updated. Moscow: Meditsinskoe informatsionnoe agentstvo; 2017. 464 p. (In Russ).

2. Belyalov FI. Klinicheskie rekomendatsii po kardiologii i komorbidnym boleznyam. 9nd ed, revised and updated. Moscow: GEOTAR-Media; 2019. 352 p. (In Russ).

3. Ministerstvo Zdravookhraneniya Rossiiskoi Federatsii, FGBU «NNPTsSSKh im. A.N. Bakuleva» MZ RF, Tsentr khirurgicheskoi interventsionnoi aritmologii. Bradiaritmii. Klinicheskie rekomendatsii. (In Russ). Available at: https://racvs.ru/clinic/files/2017/Bradyarrhythmias.pdf.

4. Bokeria OL, Akhobekov AA. Ventricular premature complexes. Annaly aritmologii. 2015;12(1):16–24. (In Russ). doi: 10.15275/annaritmol.2015.1.3.

5. Guyton AC, Hall JE. Textbook of medical physiology. Translated from English. Ed by V.I. Kobrin. Moscow: Logosfera,; 2008. 296 p. (In Russ).

6. Doshchitsin V.L. Rukovodstvo po prakticheskoi elektrokardiografii. Moscow: MEDpress-inform; 2013. 416 p. (In Russ).

7. Zabolotskikh IB, Myasnikova VV, Grigoriev EV, et al. Perioperative management of patients with bradiarithmia. Anesteziologiya i reanimatologiya. 2018;(1–2):21–38. (In Russ). doi: 10.17116/anaesthesiology201801-02121.

8. Federatsiya anesteziologov i reanimatologov. Perioperatsionnoe vedenie patsientov s zheludochkovymi takhiaritmiyami. Klinicheskie rekomendatsii. Moscow; 2018 (In Russ). Available at: http://far.org.ru/recomendation.

9. Kiyakbaev GK. Aritmii serdtsa. Osnovy elektrofiziologii, diagnostika, lechenie i sovremennye rekomendatsii. Ed by V.S. Moiseev. Moscow: GEOTAR-Media; 2014. 240 p. (In Russ).

10. Nedostup AV, Blagova OV. Kak lechit’ aritmii. Narusheniya ritma serdtsa i provodimosti v klinicheskoi praktike. 8th ed. Moscow: MEDpress-inform; 2014. 368 p. (In Russ).

11. Intensivnaya terapiya. Natsional’noe rukovodstvo, kratkoe izdanie. Ed by B.R. Gel’fand, I.B. Zabolotskikh. Moscow: GEOTAR-Media; 2017. 928 p. (In Russ).

12. Vserossiiskoe nauchnoe obshchestvo aritmologov. Klinicheskie rekomendatsii po provedeniyu elektrofiziologicheskikh issledovanii, kateternoi ablyatsii i primeneniyu implantiruemykh antiaritmicheskikh ustroistv. Moscow; 2017. (In Russ).] Available at: https://vnoa.ru/literature/.

13. Sumin AN, Sumin DA. Assessment and reduction of cardiac complications risk in non-cardiac operations: whether there are differences between European and American guidelines in 2014? Kreativnaya kardiologiya. 2015; (1):5–18. (In Russ). doi: 10.15275/kreatkard.2015.01.01.

14. Uddin LN, Gabitova MA, Sokolova AA, et al. Comparison of schemes of perioperational anticoagulation in atrial fibrillation patients demanding for surgery. Cardiovascular therapy and prevention. 2018;17(3):71–78. (In Russ). doi: 10.15829/1728-8800-2018-3-71-78.

15. Rukovodstvo po narusheniyam ritma serdtsa. Ed by E.I. Chazov, S.P. Golitsyn. Moscow: GEOTAR-Media; 2008. 416 p. (In Russ).

16. Brignole M, Auricchio A, Baron-Esquivias G, et al. 2013 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy. Eur Heart J. 2013;34(29): 2281–2329. doi: 10.1093/eurheartj/eht150.

17. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS Guideline for the management of patients with atrial fibrillation: executive summary. J Am Coll Cardiol. 2014;64(21):2246–2280. doi: 10.1016/j.jacc.2014.03.021.

18. Heidbuchel H, Verhamme P, Alings M, et al. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace. 2015;17(10):1467–1507. doi: 10.1093/europace/euv309.

19. January CT, Wann LS, Calkins H, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation, Journal of the American College of Cardiology. J Am Coll Cardiol. 2019; 74(1):104–132. doi: 10.1016/j.jacc.2019.01.011.

20. Lee TH, Marcantonio ER, Mangione CM, et al. derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999;100(10):1043–1049. doi: 10.1161/01.cir.100.10.1043.

21. The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). 2014 ESC/ESA guidelines on non-cardiac surgery: cardiovascular assessment and management. Russ J Cardiol. 2015;20(8):7–66. (In Russ). doi: 10.15829/ 1560-4071-2015-08-7-66.

For citation

Goncharov M.A. Preoperative preparation of patients with cardiac arrhythmias and conduction disorders for planned non-cardiac surgery. Bulletin of Pirogov National Medical & Surgical Center. 2019;4(14):84-89. (In Russ.) https://doi.org/10.25881/BPNMSC.2020.37.58.017