Hip replacement surgery

I am having a hip replaced on Thursday and wondered if anyone knew of evidence that a general anaesthetic might cause af to return. At present I am in sinus taking 2.5 mg of bisoprolol daily to prevent my pulse rate going too high and triggering af to return. I am also due for a lower limb nerve blocker. I have discussed it with the surgeon but haven't really had much reassurance.

31 Replies

  • I have had 2 exactly as you describe and stayed in SR. The orthos know nothing about heart. But you could have a word with the anaesthetist before you go down to tell him of your concerns. Good luck!

  • Thank you for your response. I think I will do as you suggest. It is reassuring to know you were alright.

  • I've had hip replacement no problem.Anaesthetist spoke with me before OP.knew exactly what to administer etc.He suggested epidural and injection.Was done within 1and quarter hours,sitting up chatting on way to recovery.Good luck Tony.


  • Thanks Eleanor for coming back to me. I will do as you suggest and follow their recommendation.

  • Hi Tony. You will feel so much better after your hip is replaced! I have had two hip replacements under general and epidural anaesthetics. Post op no problems, no AF but I continued to take my AF meds. However......a few weeks after the ops I then went into haywire AF and my EP said this was quite common after big operations. The heart is irritated by the drugs and hardware used during the general surgical process. It was a surprise to me but the EP reassured me that in about six months everything would settle down again and he was spot on with this information. During post op AF I was monitored by my anticoagulation and arrhythmia nurses and this was reassuring. All in all I would do it all again. Maybe you won't have any problems at all. I seem to have a very uppity heart!! Good luck. Anne

  • Interesting answer annel.I am in permanent AF.Had a general an.for a hip replace. last year following an accident.After I returned home I had a very nasty AF 'attack'Never had one before.So I guess it was the surgery that brought it on even though it had been uncomplicated.

  • Many thanks for telling me about your experience. I hadn't realised there could be effects later on. I intend to carry on with my AF medications so all I can hope is they will keep me in sinus.

  • i had a hip replacement and stayed in SR no probs then had an ablation 7 months later all went well with both

  • Thanks very reassuring.

  • Hello Tony, I had hip replacement 2.5 years ago..and I was fine, no problem whatever, so don't worry you will be good. It has made my life so much better. Good luck and don't worry


  • Thanks very much Robert you and others have been very reassuring.

  • I had both hips replaced, I am on Bisoprolol twice daily and Flecainide twice daily. My PAF returned both times when I came out of the anaesthetic. Having said that, I react to stimulants like coffee, fizzy wine, and the anaesthetic but it may be different for you. Its probably best to discuss with your Cardiologist or Electrophysiologist as the surgeon won't specialise in AF.

  • What you say is what has worried me. Unfortunately I don't think I shall be able to talk to the cardiologist beforehand.

  • I had a hip replacement 18 months ago, by epidural. It is hard to say whether the procedure can cause AF to return. I had two bouts of AF after the operation, but then it was never fully under control with the medication anyway. There is some evidence that surgical procedures, such as hip replacements, can bring on some sort of cardiac event after the op--especially for men. I first experienced AF after my first hip replacement in 2013. Never had it prior to that. Two things: If the hip needs replacing, do it. It won't get better. If you haven't been tested for sleep apnoea, do it. I have had no AF since I started on a CPAP machine. Best of luck.

  • The surgeon I went to see about my hip soon after having my aortic valve replaced and going into AF for the first time said that he would never do a hip replacement on a patient who had an aortic valve replacement.

    The three I have seen since then did not think it a problem.

  • Thanks for your reply. My sinus seems stable with the medication I am on so I can just hope it will remain. I hadn't realised there could be problems down the line, so I must watch out for that.

  • The anaesthetist will check you over before the operation. I had one who did not like my ECG and insisted that I have an echocardiogram before it as he did not want me dying on him.

    When I had my left atrial appendage procedure in April the anaesthetist put if off for an hour and a half as I had milk in my tea five hours before.

    If you have an enlarged prostate the anaesthetist can effect it and cause retention.

    Are you having a standard hip replacement or one of the newer less invasive ones that do not cut through muscles or tendons and avoid hip dislocation?

  • Thanks for getting back to me. I haven't actually seen the anaesthetist yet so I will need to check it out with him/her. I just need to be prepared and the responses here have helped. I am 78 so all I am getting is steel and plastic as this apparently will see me out.

  • Um...steel prosthesis? I hope your body can take it. Probably too late to ask you to read the prolific info on metal contamination due to steel implants--especially if they require cement. All the best. Jack

  • Yes I am well aware. I went into the consultation with all the facts. However at 78 I don't seem to have much clout I was told this combination would see me out. Also the surgeon is French and not too keen to negotiate. Some indication of future Brexit negotiations. However I shall have another go when I see him again.

  • Tony. Find out if the "steel" is not really titanium. In this country some hip prostheses were found to cause trouble later on by shedding into the blood stream with wear and tear. I thought that this particular prosthesis and metal were no longer in use. Can you google what the standard of hip prosthesis is in France? Would your French GP know? Anne

  • Hi Anne I am near Banbury and the French surgeon has been in the hospital over 10 years. I am going to query it before the operation. It's not a metal on metal in any case. Tony

  • I had both hips replaced in France--is that where you are having surgery? I went there because they use titanium coated with ceramic. Yes, the prosthesis might 'see you out'. It all depends upon your health, genes, activity level, etc. But if you become subject to metal contamination, you might end up having it done again. An unhappy but real consideration. Best, Jack

  • I appreciate your comments and am well away of the risks. I shall have further discussions when I see him next.

  • Sometimes you see the anaesthetist early at a pre assessment other times on admission. They are very careful as they don't like to lose patients.

    I'm 82 and holding off until I can get the less invasive procedure for a quicker recovery. A local surgeon in Sussex does it but I want to compare it with the SuperPath one that I would have to travel to the Midlands for.

    My hip looks terrible on X-Rays probably as I had Perthes Disease as a child but as one once said it looks much worse than it is. Over the years I've periods when it has bothered me for up to a week and returned to normal. This time it has been bothering me for about four months. Warfarin has always given me pain in my weight bearing joints and having been off it for two months I am noticing what I hope is an improvement again.

    The surgeon I saw recently said (the normal operation) it would be a complex primary but nothing dreadful!

  • I didn't see the anaesthetist at my pre-assessment but expect to before the operation so I will discuss it then. My hip problem stemmed from too much running and had deteriorated very quickly so I cannot wait. I am not even sure yet whether I shall have the less invasive procedure or not.

  • I know a few runners who needed new hips or/and knees.

    It is amazing what they can do nowadays. There is a Chinese surgeon at Hastings who evidently does both hips at once and the patient is walking the same day.

  • Yes I am hopeful things will work out well.

  • I always have more confidence in surgeons than in doctors.

  • I had a partial knee replacement under general anesthesic .... am also on warfarin ...... no problems at all! No return of AF, no problems coming off warfarin either!

  • Thanks that's very reassuring.

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