Peri-Operative Assessment of Rhythm Disturbance in Chronic Coronary Syndrome Patients Undergoing Ophthalmic Operations Detected by Holter Monitoring

Background: Chronic coronary syndrome (CCS) refers to a clinical spectrum of symptoms and signs related to myocardial ischemia due to progressive coronary artery disease. There is emerging clinical evidence that the presence of a CCS has a proarrhythmic effect. Aim: The aim of this study was to assess rhythm disturbance in chronic coronary syndrome patients undergoing ophthalmic operations. Patients and Methods: This cross-sectional comparative study conducted at Ophthalmology department at Al-Azhar university hospital – New Damietta in the period from June 2023 to July 2024 on 100 patients who are scheduled to undergo ophthalmic operations divided into two matched groups for age and sex; group (A) included 50 patients who were diagnosed as chronic coronary syndrome as a study group (their mean ages were 58.9 ± 9.2 years) and group (B) included 50 patients who had no previous history of cardiac diseases as a control group (their mean ages were 56.4 ± 4 years). Results: Infrequent PVCs were the most common abnormal finding observed in group A preoperatively and postoperatively (12% and 20% respectively). While intraoperatively, the most common observed abnormality was sinus tachycardia (38%). In group B, throughout the study the most frequent abnormality observed was sinus tachycardia. It was observed in 16%, 40%, and 32%, preoperative, intraoperative, and postoperative respectively. DM and HTN were the independent predictors of arrhythmia and patients with DM or HTN more susceptible for perioperative arrhythmia. Conclusion: Patients with CCS are at higher risk for perioperative rhythm disturbance than normal population. This risk increases in patients with DM and HTN and they are more susceptible for perioperative arrhythmia.