心房颤动与冠状动脉旁路手术的关系。
Relationshi̇p between atrial fibrillation and coronary bypass surgery.
机构信息
Sedat Ozcan, Department of Cardiovascular Surgery, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey.
出版信息
Pak J Med Sci. 2014 May;30(3):630-3. doi: 10.12669/pjms.303.4762.
OBJECTIVE
Atrial fibrillation (AF) is the most common arrhythmia seen after coronary artery surgery. The purpose this study was to determine incidence of AF that develops after coronary surgery and the factors affecting its development.
METHODS
Four hundred and forty eight patients who had coronary bypass surgery between February 2007 and September 2011 in the Cardiovascular Surgery Clinic were included in the study. Patients with history of chronic renal failure, redo coronary bypass surgery, valvular disease, thyroid disease, ventricular aneurysm and treatment with beta-blockers were excluded from the study of EF.
RESULTS
Two hundred and ninety nine patients were male and 149 were female and their age varied between 38 and 85 and their mean age was 61±5. Surgery was performed on beating heart on 178 patients and the others were operated with cardiopulmonary bypass (CPB). Advanced age, male sex and history of hypertension was more in AF developed patient group. There was no difference between AF developed group and the other group in terms of diameter of left atrium, ejection fraction (EF), CPB time and cross clamp time.
CONCLUSION
Advanced age, male sex, hypertension and prolonged P-wave duration are the factors that are associated with AF after coronary surgery. Avoidance of CPB does not decrease AF development.
目的
心房颤动（AF）是冠状动脉手术后最常见的心律失常。本研究旨在确定冠状动脉手术后发生 AF 的发生率以及影响其发生的因素。
方法
本研究纳入了 2007 年 2 月至 2011 年 9 月期间在心血管外科诊所接受冠状动脉旁路移植术的 448 例患者。排除了有慢性肾功能衰竭、再次冠状动脉旁路移植术、瓣膜疾病、甲状腺疾病、心室动脉瘤病史以及接受β受体阻滞剂治疗的患者。
结果
299 例患者为男性，149 例为女性，年龄在 38 岁至 85 岁之间，平均年龄为 61±5 岁。178 例患者在心脏跳动下进行手术，其余患者在体外循环（CPB）下进行手术。AF 组患者的年龄较大、男性和高血压病史较多。AF 组与其他组之间的左心房直径、射血分数（EF）、CPB 时间和体外循环时间无差异。
结论
年龄较大、男性、高血压和 P 波延长是与冠状动脉手术后发生 AF 相关的因素。避免 CPB 并不能降低 AF 的发生。
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