Hashemzadeh Khosrow, Dehdilani Marjan, Dehdilani Mahnaz
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
J Cardiovasc Thorac Res. 2013;5(2):45-9. doi: 10.5681/jcvtr.2013.010. Epub 2013 Jun 27.
To examine whether or not off-pump CABG (Coronary Artery Bypass Reduce) reduces the incidence of AF after cardiac surgery.
The study was carried out in 939 consecutive coronary artery disease patients with sinus rhythm from which 383 patients underwent off-pump CABG, and 556 patients were operated through on-pump CABG. All patients were monitored postoperatively during intensive care unit (ICU) stay. Then, the incidence and predictive risk factors of post operative AF (POAF) in two groups were determined and compared with each other.
Overall, the mean age of the patients was 56.0±12.8 years with 234 patients (24.9%) being older than 65 years. POAF developed in 38 patients (9.9%) of the off-pump and in 93 patients (16.7%) of the on-pump CABG. There was significant difference between two groups when considering the incidence of POAF (P=0.002). Among preoperative risk factors, age>65 years had a significant association with the incidence of AF in both groups. This study also showed that most of the POAF cases converted to sinus rhythm after treatment. Moreover, these finding demonstrated that conversion to sinus rhythm is significantly more probable in off-pump group (P=0.006).
A reduced prevalence of POAF could be observed in patients with off-pump as compared with on-pump techniques. Furthermore, conversion to sinus rhythm in off-pump group was significantly more probable than on-pump group.
探讨非体外循环冠状动脉搭桥术(Coronary Artery Bypass Reduce,CABG)是否能降低心脏手术后房颤的发生率。
对939例连续的窦性心律冠心病患者进行研究,其中383例患者接受非体外循环冠状动脉搭桥术,556例患者接受体外循环冠状动脉搭桥术。所有患者在重症监护病房(ICU)住院期间均接受术后监测。然后,确定并比较两组患者术后房颤(POAF)的发生率及预测危险因素。
总体而言,患者的平均年龄为56.0±12.8岁,234例患者(24.9%)年龄大于65岁。非体外循环组有38例患者(9.9%)发生POAF,体外循环组有93例患者(16.7%)发生POAF。考虑POAF发生率时,两组之间存在显著差异(P = 0.002)。在术前危险因素中,年龄>65岁与两组房颤发生率均显著相关。本研究还表明,大多数POAF病例经治疗后转为窦性心律。此外,这些发现表明非体外循环组转为窦性心律的可能性明显更高(P = 0.006)。
与体外循环技术相比,非体外循环患者的POAF患病率较低。此外,非体外循环组转为窦性心律的可能性明显高于体外循环组。