Postoperative Arrhythmias After Open-Heart Surgery : Incidence, Risk Factors, and Management in Tanzania

BackgroundArrhythmias following open heart surgery are a known complication, affecting 10-57% of patients with heart disease. Despite the well-established link between cardiac surgery and risk of developing postoperative arrhythmias, there remains a paucity of data in this context to guide targeted interventions and improved patient outcomes. This study aimed to assess the incidence, factors associated with arrhythmias, therapeutic management and treatment outcomes among post-cardiac surgery patients in Tanzania. MethodsA prospective single-arm cohort study involving 100 post-cardiac surgery patients was conducted from March to June 2024 at Jakaya Kikwete Cardiac Institute (JKCI) in Dar es Salaam, Tanzania. A case report form (CRF) comprising three sections: (1) demographic and preoperative characteristics, (2) intraoperative and clinical details, and (3) postoperative information on arrhythmias was used to collect data. Post-cardiac surgery arrhythmias were diagnosed using electrocardiographic monitoring and 12-lead electrocardiograms (ECG). Analysis was conducted using SPSS version 23, with a p-value of < 0.05, considered statistically significant for associations between variables. ResultsAmong 100 post-cardiac surgery patients, 52% had a prior history of arrhythmia and 96% had rheumatic heart disease. Postoperatively, 54% developed arrhythmias, predominantly sinus tachycardia (66.7%) and atrial fibrillation (59.2%). Factors significantly associated with postoperative arrhythmias included higher body mass index (BMI), preoperative arrhythmia, and hemodynamic instability. Management primarily involved cardiac membrane stabilizers, intravenous fluids, beta-blockers, and anticoagulants. ConclusionThis study found that postoperative arrhythmias were common after open-heart surgery, predominantly sinus tachycardia and atrial fibrillation. Higher BMI, preoperative arrhythmia, and hemodynamic instability were key risk factors, underscoring the need for close monitoring of high-risk patients.