Objective: To evaluate the clinical relevance of cardiac arrhythmias during rehabilitation after coronary artery bypass graft (CABG) surgery.
Design: Survey of consecutive patients admitted to an inpatient cardiac rehabilitation center.
Setting: A rehabilitation center acting as a reference for cardiology clinics lacking this facility. The program was performed in the inpatient setting.
Patients: Two hundred sixty patients undergoing elective CABG surgery for angina.
Interventions: Four-week cardiac rehabilitation program. A 24-hour electrocardiographic examination was performed during the first 2 days and, subsequently, on a daily basis.
Main outcome measures: Incidence and type of cardiac arrhythmias during rehabilitation; identification of factors associated with an increased risk of cardiac arrhythmias.
Results: Cardiac arrhythmias were recorded in 33.5% of the patients and were more frequent in patients with hypertension (47%), diabetes (42.4%), and hyperlipidemia (36.5%), compared with patients free from these diseases (15.5%) (p < .05). Arrhythmias were also recorded in patients older than 70 years (49%), compared with those younger (29.2%) (p < .01), and in patients who discontinued amiodarone (64.3%) compared with those who did not interrupt the drug (16%) (p < .005). Arrhythmias precluded rehabilitation in 5% of the patients and caused death in one patient.
Conclusion: Surveillance for the development of cardiac arrhythmias during cardiac rehabilitation after CABG surgery may allow the early detection and treatment of arrhythmias in a substantial number of patients.