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» Survey Results

Prophylaxis and Management of Arrhythmias After Thoracic Surgery

This survey was designed to help inform readers about current practices in prophylaxis
for and management of supraventricular arrhythmias after major thoracic surgery.
Participants were asked to respond to questions regarding perioperative management
of thoracic surgery patients. They were asked to assume that their patients had
no history of cardiac arrhythmia and were undergoing esophagectomy or major lung
resection. 

The incidence of such arrhythmias was 10% to 20% in most practices, which is similar
to what is reported in the current literature. Twenty percent of surgeons used
prophylaxis routinely, most commonly a beta blocker, and half the surgeons never
used prophylaxis. A variety of drugs were used to treat SVT when it developed,
including, in descending order of frequency, amiodarone, beta blockers, digoxin,
and calcium channel blockers. 

Interestingly, the vast majority of surgeons treated the arrhythmias themselves.
Just under two thirds of respondents indicated that a cardiologist became involved
in the treatment of these arrhythmias less than 20% of the time, indicating that
the treatments provided by surgeons were generally successful.

1. What is the incidence of postoperative supraventricular arrhythmias in such patients in your practice?
		Response Percent	Response Count
10%		37.8%	70
20%		36.2%	67
30%		20.5%	38
40% or more		5.4%	10
	answered question		185
	skipped question		0

2. Do you use pharmacologic prophylaxis in this patient population?
		Response Percent	Response Count
Yes, routinely		18.4%	34
Yes, only in selected patients		34.6%	64
No		47.0%	87
	answered question		185
	skipped question		0

3. Please check all drugs you normally use for prophylaxis.
		Response Percent	Response Count
Digoxin		28.3%	32
Beta blocker		77.9%	88
Calcium channel blocker		16.8%	19
	answered question		113
	skipped question		72

4. Please check all drugs you normally use for treatment.
		Response Percent	Response Count
Digoxin		40.2%	72
Beta Blocker		60.9%	109
Calcium channel blocker		37.4%	67
Adenosine		4.5%	8
Amiodarone		79.3%	142
	answered question		179
	skipped question		6

5. When a patient develops a postoperative supraventricular arrhythmia, who initially manages this problem?
		Response Percent	Response Count
Treating surgeon		76.8%	142
Intensive care specialist		11.4%	21
Primary care physician		0.5%	1
Cardiologist		11.4%	21
	answered question		185
	skipped question		0

6. In what percentage of patients who develop supraventricular arrhythmia does a cardiologist become involved in therapy?
		Response Percent	Response Count
10%		41.6%	77
20%		18.9%	35
30%		13.5%	25
40% or more		25.9%	48
	answered question		185
	skipped question		0

7. In what region is your surgical practice based?
		Response Percent	Response Count
North America		44.3%	82
Europe		38.4%	71
South America		4.9%	9
Asia		9.7%	18
Africa		2.7%	5
	answered question		185
	skipped question		0