Background

Following bariatric surgery, many patients require anti-emetics which can cause QTc prolongation, and potentially ventricular arrhythmia. Our aim was to evaluate the prevalence of prolonged QTc intervals in post-operative bariatric patients taking anti-emetics.

Methods

We conducted a retrospective analysis of patients that underwent bariatric surgery at University of Maryland Medical Center over a one-month interval. QTc interval was recorded; an interval >440ms in men >460ms in women was considered prolonged. The data was collated in an Excel database and analyzed using descriptive statistics.

Results

A total of 29 patients were included in our study with a median age of 41.3 +- 13.7 years; 86% were female. The median BMI was 48.3+-10.9 kg/m2. Laparoscopic sleeve gastrectomy was done on 14 patients, while 15 patients had a Laparoscopic gastric bypass. All patients had pre and postoperative EKGs. All patients received anti-emetics postoperatively. Overall, 12/29 (41.4%) patients had no QTc prolongation pre or postoperatively, 6/29 (20.7%) had preoperative prolongation but normal QTc interval postoperatively, and 6/29 (20.7%) had QTc prolongation pre and postoperatively. 17.2% had new onset QTc prolongation postoperatively. No patients in this group had cardiac arrhythmias postoperatively.

Conclusions

While QTc prolonging anti-emetics are commonly used following bariatric surgery, the associated risks are not often appreciated. Nearly 40 percent of patients have prolonged QTc postoperatively, almost half of which are new onset. The new onset QTc prolongation may be attributable to anti-emetics. In the event of postoperative ventricular arrhythmia, termination of these medications must be considered to prevent fatal arrhythmia.