Siddiqi Ahmed, Talmo Carl T, Bono James V
Orthopedic Surgery Department, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania.
Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts.
Surg Technol Int. 2017 Oct 12;31:209-211.
New onset postoperative atrial fibrillation (AF) is the most common perioperative arrhythmia in the elderly. The incidence after total joint arthroplasty is much lower than other non-cardiac surgeries. Since postoperative atrial fibrillation can cause increased length of hospital stay, mortality, and healthcare costs, it is critical to focus on prevention and prompt management. New onset atrial fibrillation is treated with rhythm control for patients who demonstrate hemodynamic instability or refractory to rate control measures. Electrical cardioversion is an effective option for unstable patients with known complications. However, there is limited data on orthopedic problems after cardioversion. A unique case is reported presenting postoperative total hip arthroplasty (THA) dislocation after electrical cardioversion for new onset atrial fibrillation in the postanesthesia care unit (PACU).
新发术后房颤是老年人最常见的围手术期心律失常。全关节置换术后的发生率远低于其他非心脏手术。由于术后房颤会导致住院时间延长、死亡率增加和医疗费用上升，因此注重预防和及时处理至关重要。对于血流动力学不稳定或对心率控制措施无效的患者，新发房颤采用节律控制进行治疗。电复律是有已知并发症的不稳定患者的有效选择。然而，关于复律后骨科问题的数据有限。本文报告了1例在麻醉后监护病房（PACU）因新发房颤进行电复律后出现全髋关节置换术（THA）术后脱位的独特病例。
