F-144
SUPRAVENTRICULAR TACHYARRHYTHMIA AFTER MAJOR THORACIC SURGERY AND CARDIOPULMONARY EXERCISE TEST: THE PREDICTIVE POWER OF MINUTE VENTILATION-TO-CARBON DIOXIDE OUTPUT

Objectives: Perioperative atrial tachyarrhythmias (POAT) are the commonest arrhythmia after major lung resections. To date the relationship between POAT and cardiopulmonary exercise test (CPET) parameters were never tested after major thoracic surgery. The aim of the study was to assess the association between CPET data and postoperative complications with a particular focus on POAT and atrial fibrillation (AF).

Methods: Seventy-four consecutive patients, who underwent pulmonary lobectomy from January 2013 to June 2015, were assessed by preoperative spirometry, arterial blood gas analysis, diffusing capacity of the lungs for carbon monoxide, CPET on cycle ergometer, ECG and echocardiogram. Cardiologic and respiratory complications were recorded and matched with functional parameters to identify any potential risk factors.

Results: Cardiopulmonary morbidity, POAT, AF and respiratory failure incidences were 23 (31.1%), 22 (29.7%), 6 (8.1%) and 4 (5.4%) respectively. The following associations were found: steeper VE/VCO₂ slope (P = 0.005), lower FEV1/FVC (P = 0.006) and FEV1 lower than 80% of predicted (FEV1 < 80%) (P = 0.03) with POAT. Regression analysis indicated Ve/VCO₂ (P = 0.008; HR = 1.18 [95% CI: 1.04-1.34]), FEV1/FVC (P = 0.02; HR = 0.06 [95% CI: 1.01-1.11]) and FEV1 < 80% (P = 0.03; HR = 3.30 [95% CI: 1.08-10.06]) as risk factors for POAT and among these, the only independent risks factor is VE/VCO₂ (P = 0.013; HR = 1.20 [95% CI: 1.03-1.38]). AF was associated with elderly age (P = 0.002), higher systolic pulmonary artery pressure (PAP) (P = 0.002) and lower ejection fraction (P = 0.011). Regression analysis suggested that PAP (P = 0.03; HR = 1.44 [95% CI: 1.01-2.05]) and elderly age (P = 0.024; HR = 1.18 [95% CI: 1.02-1.37]) can predict the risk of atrial fibrillation.

Conclusion: Our data suggest that VE/VCO₂ is an objective good predictor of POAT and AF is strongly correlated to age and PAPs. These data should be considered to identify patients at risk for POAT and AF and should be helpful to guide preoperative prophylactic therapy.

Disclosure: No significant relationships.