We performed a post-hoc analysis of a single-centre observational cohort study of non-cardiac surgical patients to determine whether cardiac vagal function and/or morbidity after surgery were associated with higher heart rate at the time of discharge from hospital.Īssessment of cardiac autonomic activity-time and frequency domain measures Here, we hypothesised that elevation in resting heart rate after surgery persists until at least discharge from hospital. If so, heart rate may be an overlooked modifiable risk factor for morbidity and/or mortality after discharge from hospital following surgery. However, it is unknown whether increases in perioperative heart rate persist beyond the first 72h after non-cardiac surgery. Before non-cardiac surgery, resting heart rate >87 beats minute -1 is associated with myocardial injury and poorer outcome ( 8, 9).Ī prototypical feature of the surgical stress response is loss of cardiac vagal activity, leading to higher resting heart rate ( 10). For every 10 beats minute -1 (bpm) increase in heart rate, mortality increases by 16% in patients with heart failure ( 7). Several prospective studies have identified higher heart rate at discharge from hospital as an independent prognostic predictor of morbidity and mortality in patients treated for acute myocardial infarction ( 3, 4, 5), and heart failure ( 2, 6). Elevated heart rate is a consistent, robust predictor of morbidity and mortality, including in otherwise healthy individuals ( 2). In mammals, there is an inverse semilogarithmic relation between heart rate and life expectancy suggesting that for each species, there is a predetermined number of heart beats in a lifetime ( 1).
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