Fengsrud Espen, Englund Anders, Ahlsson Anders
a Department of Cardiology and Cardiothoracic Surgery , School of Health and Medical Sciences, Örebro University Hospital , Örebro , Sweden.
b Department of Clinical Sciences , South Hospital, Arrhythmia Center, Karolinska Institute , Stockholm , Sweden.
Scand Cardiovasc J. 2017 Feb;51(1):21-27. doi: 10.1080/14017431.2016.1234065. Epub 2016 Sep 22.
To study pre- and postoperative atrial fibrillation and its long-term effects in a cohort of aortocoronary bypass surgery patients.
Altogether 615 patients undergoing aortocoronary bypass graft surgery in 1999-2000 were studied. Forty-four (7%) had preoperative atrial fibrillation. Postoperative atrial fibrillation occurred in 165/615 patients (27%) while 406/615 patients (66%) had no atrial fibrillation. After a median follow-up of 15 years, symptoms and medication in survivors were recorded, and cause of death in the deceased was obtained.
Death due to cerebral ischaemia was most common in the pre- and postoperative atrial fibrillation groups (7% and 5%, respectively, v. 2% among those without atrial fibrillation, p = .038), as were death due to heart failure (18% and 14%, v. 7%, p = .007) and sudden death (9% and 5%, v. 2%, p = .029). The presence of pre- or postoperative atrial fibrillation was an independent risk factor for late mortality (hazard ratios 1.47 (1.02-2.12) and 1.28 (1.01-1.63), respectively).
Patients with pre- or postoperative atrial fibrillation undergoing aortocoronary bypass surgery have increased long-term mortality and risk of cerebral ischemic and cardiovascular death compared with patients in sinus rhythm.
研究一组接受主动脉冠状动脉搭桥手术患者术前和术后房颤及其长期影响。
对1999年至2000年期间接受主动脉冠状动脉搭桥移植手术的615例患者进行了研究。44例（7%）患者术前有房颤。165/615例患者（27%）术后发生房颤，而406/615例患者（66%）无房颤。在中位随访15年后，记录幸存者的症状和用药情况，并获取死亡患者的死亡原因。
脑缺血导致的死亡在术前和术后房颤组中最为常见（分别为7%和5%，无房颤患者中为2%，p = 0.038），心力衰竭导致的死亡（18%和14%，无房颤患者中为7%，p = 0.007）和猝死（9%和5%，无房颤患者中为2%，p = 0.029）也是如此。术前或术后房颤的存在是晚期死亡的独立危险因素（风险比分别为1.47（1.02 - 2.12）和1.28（1.01 - 1.63））。
与窦性心律患者相比，接受主动脉冠状动脉搭桥手术的术前或术后房颤患者长期死亡率增加，脑缺血和心血管死亡风险增加。
