Avila Neto Vicente, Costa Roberto, Silva Kátia Regina, Martins André Luiz Mendes, Moreira Luiz Felipe Pinho, Santos Letícia Bezerra, Melo Ricardo F de Azevedo
Hospital São Joaquim da Benemérita Associação Portuguesa de Beneficência de São Paulo, Brazil.
Rev Bras Cir Cardiovasc. 2007 Jul-Sep;22(3):332-40. doi: 10.1590/s0102-76382007000300010.
To evaluated the effects of temporary atrial pacing to prevent the atrial fibrillation following coronary artery bypass graft surgery and the risk factors to the occurrence of this arrhytmia.
We have studied 160 patients who, at the end of coronary artery bypass graft surgery, were submitted to epicardial electrode implantation in the right atrium lateral wall. They were randomized into two groups: non-pacing (NP) group and right atrial (RA) pacing group. The cardiac rhythm was monitorized over 72 hours following to the end of surgery and the variables studied were as follow: incidence of atrial fibrillation; the risk factors pre-, intra-, and postoperative for its occurrence, and postoperative events.
There were 21 (13.1%) episodes of atrial fibrillation, 20 in the NP group and one in the RA group. The relative risk (RR) for the development of atrial fibrillation was 0.18 (95% CI; 0.05-0.60) for the RA group when compared to the NP group. The logistic regression identified that the study variables, such as younger age; use of beta-blockers in the preoperative, and the presence of right atrial pacing had been associated to a lower Odds ratios (ORs) for the occurrence of atrial fibrillation in the postoperative.
The temporary atrial pacing reduced the incidence of atrial fibrillation after the CABG surgery. Older age and a non-atrial pacing were the independent predictive factors of the occurrence of this arrhythmia.
评估临时心房起搏预防冠状动脉旁路移植术后房颤的效果以及该心律失常发生的危险因素。
我们研究了160例在冠状动脉旁路移植手术结束时于右心房外侧壁植入心外膜电极的患者。他们被随机分为两组：非起搏（NP）组和右心房（RA）起搏组。术后72小时监测心律，研究的变量如下：房颤发生率；术前、术中和术后发生房颤的危险因素以及术后事件。
共有21例（13.1%）发生房颤，NP组20例，RA组1例。与NP组相比，RA组发生房颤的相对风险（RR）为0.18（95%CI：0.05 - 0.60）。逻辑回归分析确定，研究变量如年龄较小、术前使用β受体阻滞剂以及存在右心房起搏与术后发生房颤的较低比值比（OR）相关。
临时心房起搏降低了冠状动脉旁路移植术后房颤的发生率。年龄较大和非心房起搏是该心律失常发生的独立预测因素。
