Supraventricular arrhythmias are common rhythmdisturbances following pulmonary surgery.The overall incidence varies between\r\n3.2% and 30% in the literature, while atrial fibrillation is the most common form. These arrhythmias usually have an uneventful\r\nclinical course and revert to normal sinus rhythm, usually before patent�s discharge from hospital. Their importance lies in\r\nthe immediate hemodynamic consequences, the potential for systemic embolization and the consequent long-term need for\r\nprophylactic drug administration, and the increased cost of hospitalization. Their incidence is probably related to the magnitude\r\nof the performed operative procedure, occurring more frequently after pneumonectomy than after lobectomy. Investigators\r\nbelieve that surgical factors (irritation of the atria per se or on the ground of chronic inflammation of aged atria), direct injury\r\nto the anatomic structure of the autonomic nervous system in the thoracic cavity, and postthoracotomy pain may contribute\r\nindependently or in association with each other to the development of these arrhythmias. This review discusses currently available\r\ninformation about the potential mechanisms and risk factors for these rhythmdisturbances. The discussion is in particular focused\r\non the role of postoperative pain and its relation to the autonomic imbalance, in an attempt to avoid or minimize discomfort with\r\nproper analgesia utilization.
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