Abstract: Objective To investigate the risk of malignant arrhythmia during the perioperative period of abdominal aortic aneurysm repair surgery using electrocardiogram J waves. Methods Eighty patients who were scheduled to undergo abdominal aortic aneurysm repair surgery between January 2020 and August 2024 were selected and grouped based on whether they had J waves on their electrocardiogram： an observation group （with J waves on the electrocardiogram, n=44） and a control group （without J waves on the electrocardiogram, n=36）. The occurrence of malignant arrhythmia in the two groups of patients were analyzed. Result The included 80 abdominal aortic aneurysm patients successfully completed surgery. Among them, 12 patients in the observation group experienced malignant arrhythmia, while 2 patients in the control group did. There was a statistically significant difference in the incidence of malignant arrhythmia between the two groups （27.27% vs. 5.56%, χ²=6.468, P=0.011）. Based on electrocardiogram, the patients in the observation group were divided into a large J wave subgroup （n=29） and a small J wave subgroup （n=15）, and there was no statistically significant difference in the incidence of malignant arrhythmia between the subgroups （34.83% vs. 13.33%, χ²=1.291, P=0.256）. Conclusion Patients undergoing abdominal aortic aneurysm repair surgery have a high risk of developing malignant arrhythmia during the perioperative period, and there is a potential association between electrocardiogram J waves and the risk of malignant arrhythmia.

Key words: Abdominal aortic aneurysm repair surgery, Electrocardiogram, J wave, Malignant arrhythmia