Koçoğullari Cevdet Uğur, Emmiler Mustafa, Ayva Ercument, Sasirtan Taner, Eren Naim, Cekirdekci Ahmet
Department of Cardiovascular Surgery, Medical Faculty, Kocatepe University, Afyon, Turkey.
Heart Surg Forum. 2008;11(3):E159-63. doi: 10.1532/HSF98.20081003.
We investigated the effects of preoperative administration of beta-blockers on the incidence of atrial fibrillation (AF) after cardiothoracic surgery and the resulting morbidity and mortality.
We retrospectively evaluated 181 patients who underwent operations between May 2004 and December 2007. We divided the patients into 2 groups according to their preoperative use beta-blockers. Group A (n = 89) consisted of patients who did not receive beta-blockers, and group B (n = 92) consisted of patients who received 50 mg metoprolol succinate daily. All patients underwent on-pump coronary artery bypass grafting (CABG) via sternotomy.
Atrial sizes and the baseline clinical and laboratory data were similar for the 2 groups. The 2 groups were also similar with respect to the numbers of grafts per patient, preoperative ejection fractions, cross-clamp times, cardiopulmonary bypass times, and postoperative inotrope use (P > .05). AF occurred in 39 (21.5%) of the 181 patients after the operation. Postoperative AF occurred in 30 (33.7%) of the group A patients and in 9 patients (9.7%) in group B (P < .05).
Postoperative AF increases the rates of morbidity and mortality and the length of hospital stay after CABG. The prophylactic use of beta-blockers decreases the rate of postoperative AF and thus AF-related complications.
我们研究了术前给予β受体阻滞剂对心胸外科手术后房颤（AF）发生率以及由此产生的发病率和死亡率的影响。
我们回顾性评估了2004年5月至2007年12月期间接受手术的181例患者。根据术前是否使用β受体阻滞剂将患者分为两组。A组（n = 89）由未接受β受体阻滞剂的患者组成，B组（n = 92）由每天接受50 mg琥珀酸美托洛尔的患者组成。所有患者均通过胸骨切开术进行体外循环冠状动脉搭桥术（CABG）。
两组患者的心房大小以及基线临床和实验室数据相似。两组在每位患者的移植血管数量、术前射血分数、阻断时间、体外循环时间以及术后使用血管活性药物方面也相似（P >.05）。181例患者术后有39例（21.5%）发生房颤。A组患者术后房颤发生率为30例（33.7%），B组为9例（9.7%）（P <.05）。
术后房颤会增加CABG后的发病率、死亡率以及住院时间。预防性使用β受体阻滞剂可降低术后房颤发生率，从而减少与房颤相关的并发症。
