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6.13. Diabetes .............................................................................................. 3889 6.14. Cancer ................................................................................................. 3889 6.15. Coronavirus disease 2019 ........................................................... 3889 7. Peri-operative monitoring and anaesthesia .................................... 3890 7.1. Peri-operative monitoring ............................................................. 3890 7.2. Anaesthesia .......................................................................................... 3891 7.2.1. Intra-operative haemodynamics ......................................... 3891 7.2.2. Choice of anaesthetic agent ................................................. 3892 7.3. Locoregional techniques ................................................................ 3892 7.4. Peri-operative goal-directed haemodynamic therapy ....... 3893 7.5. Post-operative management ......................................................... 3893 8. Peri-operative cardiovascular complications .................................. 3893 8.1. Peri-operative myocardial infarction/injury ............................ 3894 8.2. Spontaneous myocardial infarction (after day 2) ................ 3897 8.3. Takotsubo syndrome ....................................................................... 3897 8.4. Acute heart failure ............................................................................ 3897 8.5. Venous thromboembolism ........................................................... 3897 8.6. Atrial fibrillation and other relevant arrhythmias ................ 3897 8.6.1. Prevention of post-operative atrial fibrillation ............. 3897 8.6.2. Management of post-operative atrial fibrillation ......... 3898 8.6.2.1. Rate and/or rhythm control ......................................... 3898 8.6.2.2. Prevention of atrial fibrillation-related thromboembolic complications .................................................. 3899 8.7. Peri-operative stroke ....................................................................... 3899 9. Key messages ............................................................................................... 3900 10. Gaps in evidence ...................................................................................... 3900 11. Sex differences ......................................................................................... 3901 12. ‘What to do’ and ‘what not to do’ messages from the Guidelines ........................................................................................................... 3901 13. Quality indicators .................................................................................... 3906 14. Central illustration .................................................................................. 3906 15. Supplementary data ................................................................................ 3907 16. Data availability statement ................................................................... 3907 17. Author information ................................................................................ 3907 18. Appendix ..................................................................................................... 3907 19. References .................................................................................................. 3908

Tables of Recommendations

Recommendation Table 1 — Recommendations for selection of surgical approach and impact on risk ..................................................... 3843 Recommendation Table 2 — Recommendations for all patients scheduled for non-cardiac surgery .......................................................... 3845 Recommendation Table 3 — Recommendations for patients aged ,65 years without signs, symptoms, or history of cardiovascular disease ................................................................................... 3845 Recommendation Table 4 — Recommendations for pre-operative assessment in patients with previously unknown murmur, angina, dyspnoea, or peripheral oedema .......................... 3845 Recommendation Table 5 — Recommendations for patient information ........................................................................................................ 3847 Recommendation Table 6 — Recommendations for pre-operative assessment of frailty and functional capacity ......... 3849 Recommendation Table 7 — Recommendations for pre-operative risk assessment—electrocardiography and biomarkers ......................................................................................................... 3851 Recommendation Table 8 — Recommendations for transthoracic echocardiography ............................................................... 3852 Recommendation Table 9 — Recommendations for stress imaging 3853 Recommendation Table 10 — Recommendations for coronary angiography ........................................................................................................ 3853 Recommendation Table 11 — Recommendations for lifestyle and cardiovascular risk factors ........................................................................... 3854 Recommendation Table 12 — Recommendations for pharmacological treatment ......................................................................... 3856 Recommendation Table 13 — Recommendations for use of antiplatelet therapy in patients undergoing non-cardiac surgery 3862 Recommendation Table 14 — Recommendations for interruption and resumption of anticoagulants in patients undergoing non-cardiac surgery ............................................................... 3868 Recommendation Table 15 — Recommendations for thromboprophylaxis ...................................................................................... 3869 Recommendation Table 16 — Recommendations for intra- and post-operative complications associated with anaemia ................. 3870 Recommendation Table 17 — Recommendations for intra- and post-operative complications associated with blood loss ............. 3871 Recommendation Table 18 — Recommendations for intra- and post-operative complications associated with allogeneic blood transfusion .......................................................................................................... 3871 Recommendation Table 19 — Recommendations for the timing of non-cardiac surgery and revascularization in patients with known coronary artery disease ................................................................ 3874 Recommendation Table 20 — Recommendations for management of heart failure in patients undergoing non-cardiac surgery ................................................................................................................. 3875 Recommendation Table 21 — Recommendations for management of valvular heart disease in patients undergoing non-cardiac surgery ........................................................................................ 3878 Recommendation Table 22 — Recommendations for management of known or newly diagnosed arrhythmias ...... 3880 Recommendation Table 23 — Recommendations for management of bradyarrhythmia and patients carrying cardiac implantable devices ........................................................................................ 3882 Recommendation Table 24 — Recommendations for management of patients with adult congenital heart disease undergoing non-cardiac surgery ............................................................... 3883 Recommendation Table 25 — Recommendations for pericardial diseases ................................................................................................................ 3884 Recommendation Table 26 — Recommendations for patients with pulmonary arterial hypertension undergoing non-cardiac surgery ................................................................................................................. 3885 Recommendation Table 27 — Recommendations for pre-operative management of hypertension ...................................... 3886 Recommendation Table 28 — Recommendations for management of patients with peripheral artery disease and/or abdominal aortic aneurysm undergoing non-cardiac surgery ......................................................................................................... 3887 Recommendation Table 29 — Recommendations for management of patients with suspected or established carotid artery disease undergoing non-cardiac surgery ................................. 3887 Recommendation Table 30 — Recommendations for management of patients with renal disease undergoing non-cardiac surgery ........................................................................................ 3888 Recommendation Table 31 — Recommendations for management of patients with obesity undergoing non-cardiac surgery ................................................................................................................. 3888

ESC Guidelines                                                                                                                                                                                     3829

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