PMID: 19936462Nov 26, 2009Paper

Peri-operative evaluation by holter in elderly patients submitted to prostatectomy

Arquivos brasileiros de cardiologia
Thais Orrico de Brito CançadoFábio Sândoli de Brito

Abstract

Male patients, aged over 65 years and with no history of heart disease, need the following tests as a preoperative evaluation: blood count, electrocardiogram and X-ray of the chest. To verify the presence of ischemic and heart rate changes and the impact of the anesthetic procedure on these patients. Also to verify, in this population, the value of continuous ambulatory monitoring as a preoperative evaluation, a procedure that is not recommended by current guidelines. In this protocol, we used continuous ambulatory monitoring (Holter System), in the perioperative period of 30 patients, aged over 65 years, who underwent transurethral resection of the prostate under spinal anesthesia. In the preoperative and transoperative evaluations, frequent complex ventricular and supraventricular arrhythmias were observed, and also ischemic changes. In the transoperative recording, the patients who had ischemic episodes were the same ones who showed total ischemic burden of more than 60 minutes in the preoperative recording. Ambulatory monitoring is not regarded as an appropriate procedure for the screening of myocardial ischemia, due to the characteristics and technical limitations of the method, especially in populations with a low prevale...Continue Reading

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