Prevalencia de arritmias en pacientes mayores a 35 años intervenidos por cirugía de revascularización miocárdica ingresados en la unidad de cuidados intensivos del Hospital Alcívar en el periodo 2022 al 2024.

Abstract

Introduction: Postoperative arrhythmias are common complications in patients undergoing myocardial revascularization surgery, significantly affecting morbidity and mortality. These cardiac rhythm disturbances may derive from surgical manipulation, inflammatory response, and postoperative stress, with a worldwide incidence of 15-20%. In Ecuador, solid studies on its prevalence are lacking. This study aims to identify the prevalence of arrhythmias in patients older than 35 years undergoing myocardial revascularization surgery at Hospital Alcivar from 2021 to 2024. Methodology: This is a descriptive, cross-sectional, retrospective study based on the review of medical records of patients older than 35 years who underwent myocardial revascularization surgery. Data were collected from medical records, organized in Excel, and analyzed with SPSS 26.0, using descriptive and inferential statistical tests. Results: This study included 335 patients who underwent myocardial revascularization surgery, 16.42% developed postoperative arrhythmias. Most patients were older than 65 years (57.61%) and with arterial hypertension (56.41%). The most common arrhythmias were de novo atrial fibrillation (43.63%). Mortality in patients with arrhythmias was 45.45%, and a significant association was identified between arrhythmias and post-surgical complications (p = 0.001), presence of comorbidities (p = 0.003*) and multivessel disease (p = 0.001). Logistic regression showed a strong association before the presence of arrhythmias and discharge condition (OR 29.01, p < 0.001). Conclusions: Postoperative arrhythmias in myocardial revascularization surgery are significant, with atrial fibrillation being the most frequent, with a high mortality rate. Factors such as age, hypertension, postoperative complications, stent placement and multivessel disease increase the risk of arrhythmias and affect clinical outcome.