Raiten Jesse, Patel Prakash A, Gutsche Jacob
Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
Semin Cardiothorac Vasc Anesth. 2015 Jun;19(2):122-9. doi: 10.1177/1089253214551283.
Postoperative atrial fibrillation (AF) is a common arrhythmia following cardiac surgery and contributes to patient morbidity, prolonged hospital stay, and increased financial costs. The risk of postoperative AF may increase based on patient characteristics or events that occur intraoperatively or postoperatively. An understanding of these risks may be helpful in identifying which patients would benefit from prevention strategies. Acute AF presentation may range from completely indolent to rapidly progressing hemodynamic instability. Patients without hemodynamic compromise can be managed conservatively with rate control or initiation of antiarrhythmic medications. Patients with significant hemodynamic instability should undergo direct current cardioversion. In the postoperative period, it is reasonable to initiate anticoagulation after 48 hours of sustained AF or frequent episodes of postoperative AF.
术后心房颤动（AF）是心脏手术后常见的心律失常，会导致患者发病、住院时间延长和费用增加。术后AF的风险可能会因患者特征或术中或术后发生的事件而增加。了解这些风险可能有助于确定哪些患者将从预防策略中受益。急性AF的表现范围从完全无症状到迅速进展为血流动力学不稳定。没有血流动力学障碍的患者可以通过控制心率或开始使用抗心律失常药物进行保守治疗。有明显血流动力学不稳定的患者应接受直流电复律。在术后阶段，在持续性AF持续48小时或术后频繁发生AF后开始抗凝治疗是合理的。
