Heart rate and outcome in patients with cardiovascular disease undergoing major noncardiac surgery

Anaesthesia and Intensive Care
B M Biccard

Abstract

There is an increasing awareness that an elevated resting heart rate is associated with increased all-cause mortality in the general population and that this may be an independent coronary risk factor This review was undertaken to determine whether heart rate is predictive of increased mortality and major morbidity in noncardiac surgical patients and whether heart rate manipulation improves perioperative outcome. A search of Medline from 1966 until October 2007 was conducted using the terms "heart rate", "surgery", "cardiac", "morbidity", "mortality" and "perioperative". The main findings were that an elevated perioperative heart rate, an absolute increase in heart rate and heart rate lability are independent predictors of both short- and long-term adverse outcomes in patients at cardiovascular risk undergoing major noncardiac surgery. Although prospective nonrandomised and retrospective data suggest heart rate control improves perioperative outcome, there is conflicting evidence from randomised trials that perioperative heart rate control improves outcome. This may be because drug-associated bradycardia influences mortality in the perioperative period. Further studies reporting the absolute heart rate, the absolute change of h...Continue Reading

References

Oct 20, 1977·The New England Journal of Medicine·L GoldmanE E Slater
Aug 1, 1989·American Journal of Surgery·P F PasternackA M Imparato
Jun 1, 1987·American Heart Journal·W B KannelL A Cupples
Mar 1, 1995·Journal of Clinical Anesthesia·L A FleisherS H Rosenbaum
Dec 20, 1994·Proceedings of the National Academy of Sciences of the United States of America· Azbel MYa
Oct 8, 1997·Journal of the American College of Cardiology·H J Levine
Feb 26, 2000·Journal of Internal Medicine·A ReunanenA Aromaa
Jun 13, 2001·Journal of the American College of Cardiology·G LandesbergC Weissman
Feb 21, 2002·Journal of Vascular Surgery·Yaron SternbachRichard M Green
Feb 21, 2002·American Journal of Human Genetics·Koustubh RanadeNeil Risch
Aug 22, 2002·Human Genetics·Jemma B WilkR Curtis Ellison
Mar 14, 2003·Journal of Cardiothoracic and Vascular Anesthesia·Giora Landesberg
Apr 6, 2004·British Journal of Anaesthesia·D R Goldhill, A F McNarry
Jun 1, 2004·British Journal of Anaesthesia·S J Howell, J W Sear
Jun 10, 2004·JAMA : the Journal of the American Medical Association·Kim A EagleUNKNOWN GRACE Investigators
Jul 3, 2004·Journal of Cardiothoracic and Vascular Anesthesia·Keith J Anderson, John W Sear
Oct 13, 2004·The American Journal of Cardiology·Stéphane RinfretThomas H Lee
Jan 7, 2005·The New England Journal of Medicine·Paul M RidkerUNKNOWN Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 (PROVE IT-TIMI 22) Inv
Mar 3, 2005·The Journal of Nutritional Biochemistry·Mark P Mattson, Ruiqian Wan
Apr 28, 2005·The Journal of Experimental Biology·John R Speakman
Jun 21, 2005·Lancet·Ken HillmanUNKNOWN MERIT study investigators

❮ Previous
Next ❯

Citations

Jun 10, 2010·Anaesthesia·B M Biccard, R N Rodseth

❮ Previous
Next ❯

Related Concepts

Related Feeds

Bradyarrhythmias

Bradyarrhythmias are slow heart rates. Symptoms may include syncope, dizziness, fatigure, shortness of breath, and chest pains. Find the latest research on bradyarrhythmias here.