Arrhythmias complicating the surgical treatment of lung carcinoma

A series of 286 cases of pulmonary neoplasm, undergoing surgical treatment, has been investigated to determine the incidence and ˦tiology of disturbances of cardiac rhythm. Fifty-nine patients, or 20·6 per cent., developed ectopic rhythms, all of which were supraventricular in type. Auricular fibrillation was the commonest arrhythmia occurring in 41 patients (70 per cent.). Auricular fibrillation and flutter together accounted for 52 (88 per cent.) of the total of 59 arrhythmias. Most occurred in the first post-operative week (85 per cent.) and all within two weeks. The average duration was four days. In 2 patients death was directly attributed to the arrhythmia. Permanent arrhythmia developed in only 2 patients, both of whom had paroxysms of auricular fibrillation before operation. The main factors of ˦tiological importance were pre-operative cardiovascular disorders, particularly rhythm and conduction disturbances, and various post-operative complications causing anoxia and vagal reflexes. The management and prevention of the rhythm disorders is discussed.