Yadava Mrinal, Hughey Andrew B, Crawford Thomas Christopher
Division of Cardiology, Department of Medicine, University of Michigan, 1500 East Medical Center Drive, SPC 5856, Ann Arbor, MI 48109, USA; Department of Medicine, Michigan State University, 788 Service Road, Rm B301, East Lansing, MI 48824, USA.
Division of Cardiology, Department of Medicine, University of Michigan, 3116 Taubman Center, SPC 5368, Ann Arbor, MI 48109, USA.
Heart Fail Clin. 2016 Apr;12(2):299-308. doi: 10.1016/j.hfc.2015.08.023.
Atrial fibrillation is the most commonly encountered arrhythmia after cardiac surgery. Although usually self-limiting, it represents an important predictor of increased patient morbidity, mortality, and health care costs. Numerous studies have attempted to determine the underlying mechanisms of postoperative atrial fibrillation (POAF) with varied success. A multifactorial pathophysiology is hypothesized, with inflammation and postoperative β-adrenergic activation recognized as important contributing factors. The management of POAF is complicated by a paucity of data relating to the outcomes of different therapeutic interventions in this population. This article reviews the literature on epidemiology, mechanisms, and risk factors of POAF, with a subsequent focus on the therapeutic interventions and guidelines regarding management.
心房颤动是心脏手术后最常见的心律失常。虽然通常为自限性，但它是患者发病率、死亡率和医疗保健成本增加的重要预测指标。许多研究试图确定术后心房颤动（POAF）的潜在机制，但取得的成功程度各异。据推测其病理生理是多因素的，炎症和术后β-肾上腺素能激活被认为是重要的促成因素。由于缺乏关于该人群不同治疗干预结果的数据，POAF的管理变得复杂。本文回顾了关于POAF的流行病学、机制和危险因素的文献，随后重点关注治疗干预措施和管理指南。
