Koyfman Leonid, Brotfain Evgeni, Kutz Ruslan, Frenkel Amit, Schwartz Andrei, Boniel Avi, Zlotnik Alexander, Klein Moti
Department of Anesthesiology And Critical Care, Ben Gurion University of the Negev, Beer Sheva, Israel.
Anaesthesiol Intensive Ther. 2015;47(4):309-14. doi: 10.5603/AIT.a2015.0040. Epub 2015 Jul 26.
Evidence of various cardiac arrhythmias in septic patients has been demonstrated by multiple clinical reports and observations. Most cardiac arrhythmias in sepsis are new-onset and may be related to sepsis-induced myocardial dysfunction. We propose to investigate and analyze data of new-onset paroxysmal atrial fibrillation (AF) in a critically ill septic population.
This is a retrospective epidemiologic study. We collected clinical data from two hundred septic patients who developed a new episode of atrial fibrillation during their hospitalization in General Intensive Care Unit (GICU) between January 2007 and June 2013.
Of these 200 septic patients, 81 septic patients developed a new episode of AF and included in the present study. Thirty-seven patients had no past medical history of atrial fibrillation (AF) or antiarrhythmic therapy (new episode of atrial fibrillation, Group 1) and 44 had previously known episodes of atrial fibrillation and were prescribed antiarrhythmic therapy at home (Group 2). Group 2 patients had longer duration of recurrent episodes of atrial fibrillation compared to patients in Group 1 (11.07 ± 8.7 vs. 7.4 ± 6.1 days; P = 0.013). The overall ICU and in-hospital mortality rate was similar in both study groups. There was no significant difference in new stroke and pulmonary embolism (PE) between both study groups (P > 0.05).
In the present study we demonstrated no difference in morbidity and mortality rate in-ICU and after discharge between septic patients who had previous AF episodes and patients who had no previous past medical history of any cardiac arrhythmias.
多项临床报告和观察已证实脓毒症患者存在各种心律失常。脓毒症中的大多数心律失常为新发，可能与脓毒症诱导的心肌功能障碍有关。我们建议对危重症脓毒症患者新发阵发性心房颤动（AF）的数据进行调查和分析。
这是一项回顾性流行病学研究。我们收集了200例在2007年1月至2013年6月期间于综合重症监护病房（GICU）住院期间发生新发房颤的脓毒症患者的临床资料。
在这200例脓毒症患者中，81例发生新发房颤并纳入本研究。37例患者既往无房颤病史或抗心律失常治疗史（新发房颤，第1组），44例既往有房颤发作史且在家中接受抗心律失常治疗（第2组）。与第1组患者相比，第2组患者房颤复发持续时间更长（11.07±8.7天对7.4±6.1天；P=0.013）。两个研究组的总体ICU和住院死亡率相似。两个研究组之间新发卒中与肺栓塞（PE）无显著差异（P>0.05）。
在本研究中，我们证明既往有房颤发作的脓毒症患者与既往无任何心律失常病史的脓毒症患者在ICU内及出院后的发病率和死亡率方面无差异。
