Harvard Heart Letter

Ask the doctor: Does joint replacement surgery cause heart rhythm problems?

Q. Six months after having my knee replaced (at age 88!), I developed a cardiac arrhythmia. I know of this happening to several other people, including a friend who developed an arrhythmia two months after having his hip replaced at age 76. Does joint replacement surgery often cause heart rhythm problems?

A. Major surgery, like hip replacement or bypass surgery, commonly causes temporary disturbances in the heart rhythm. These are usually linked to the stress of surgery. The rhythm usually returns to normal. For people who were already headed toward developing an arrhythmia, the surgery may speed things up. Sometimes the intense monitoring that patients get during and after surgery reveals a silent pre-existing arrhythmia.

Since I am not an expert in joint replacement surgery, I turned to Dr. Thomas S. Thornhill, chair of the department of orthopedic surgery at Harvard-affiliated Brigham and Women's Hospital. He said that joint replacement surgery can cause small bits of fat to get into the bloodstream, which can trigger an arrhythmia during the postoperative period but not several months later, and that there is no evidence that orthopedic surgery causes arrhythmias.

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