Tsuboi Junichi, Kawazoe Kohei, Izumoto Hiroshi, Okabayashi Hitoshi
Department of Cardiovascular Surgery, Iwate Medical University, Memorial Heart Center, 1-2-1 Chuodori, Morioka 020-8505, Japan.
Circ J. 2008 Apr;72(4):588-91. doi: 10.1253/circj.72.588.
Arrhythmias following cardiovascular surgery lead to unstable hemodynamics, along with myocardial ischemia and decreased cardiac output. The purpose of the present case cohort study compared the control group with no carvedilol administered and the other group of patients given carvedilol and determined whether postoperative treatment with carvedilol, a beta-adrenergic blocker, prevents paroxysmal atrial fibrillation after coronary artery bypass grafting (CABG).
Of 160 patients who underwent scheduled isolated CABG, 80 received postoperative carvedilol and 80 did not. Postoperative paroxysmal atrial fibrillation was defined as episodes of atrial fibrillation persisting for over 10 min and confirmed by 12-lead electrocardiography. The incidence of paroxysmal atrial fibrillation was significantly lower in patients given carvedilol (12/80:15%) than in those who were not (27/80:34%) (p=0.0094). Logistic regression analysis showed that only postoperative carvedilol was significantly associated with the development of postoperative atrial fibrillation (95% confidence interval, 0.169-0.832; p=0.0159).
Postoperative treatment with carvedilol prevented paroxysmal atrial fibrillation after CABG.
心血管手术后的心律失常会导致血流动力学不稳定,同时伴有心肌缺血和心输出量降低。本病例队列研究的目的是比较未服用卡维地洛的对照组和另一组服用卡维地洛的患者,并确定β受体阻滞剂卡维地洛术后治疗能否预防冠状动脉旁路移植术(CABG)后的阵发性心房颤动。
在160例行择期单纯CABG的患者中,80例术后接受卡维地洛治疗,80例未接受。术后阵发性心房颤动定义为持续超过10分钟的心房颤动发作,并经12导联心电图证实。服用卡维地洛的患者阵发性心房颤动的发生率(12/80:15%)显著低于未服用者(27/80:34%)(p=0.0094)。逻辑回归分析显示,只有术后卡维地洛与术后心房颤动的发生显著相关(95%置信区间,0.169 - 0.832;p=0.0159)。
卡维地洛术后治疗可预防CABG后的阵发性心房颤动。