Alawami Mohammed, Chatfield Andrew, Ghashi Rajaie, Walker Laurence
Cardiology Department, Auckland City Hospital, Auckland, New Zealand.
Science Department, Auckland University, Auckland, New Zealand.
J Saudi Heart Assoc. 2018 Jan;30(1):40-46. doi: 10.1016/j.jsha.2017.03.008. Epub 2017 Mar 24.
Atrial fibrillation (AF) after cardiac surgery is a major health problem that is associated with a significant financial burden. This paper aims to highlight this problem and review the current guidelines in the prevention and management of AF after cardiac surgery, providing our experience in the Australasian centers.
We conducted a literature review using mainly PubMed to compare the current practice with the available evidence. EMBASE and Cochrane library were also searched. We concurrently developed an online questionnaire to collect data from other Australasian centers regarding their approach to this problem.
We identified 194 studies that were considered relevant to our research. We did not find any formal protocols published in the literature. From our Australasian experience; seven centers (58%) had a protocol for AF prophylaxis. The protocols included electrolytes replacement, use of amiodarone and/or β-blockers. Other strategies were occasionally used but were not part of a structured protocol.
The development of an integrated medical and surgical protocol for the prophylaxis of AF after cardiac surgery is an important aspect for the care of postoperative cardiac patients. Considerations of prophylactic strategies other than those routinely used should be included in the protocol. This area should receive considerable attention in order to reduce the postoperative complications and health costs.
心脏手术后房颤是一个重大的健康问题，会带来巨大的经济负担。本文旨在强调这一问题，并回顾心脏手术后房颤预防和管理的现行指南，分享我们在澳大利亚和新西兰各中心的经验。
我们主要使用PubMed进行文献综述，以比较当前实践与现有证据。同时也检索了EMBASE和Cochrane图书馆。我们还同步开发了一份在线问卷，从澳大利亚和新西兰的其他中心收集关于他们处理该问题方法的数据。
我们确定了194项与我们研究相关的研究。我们在文献中未发现任何正式的方案。根据我们在澳大利亚和新西兰的经验，七个中心（58%）有房颤预防方案。这些方案包括电解质补充、使用胺碘酮和/或β受体阻滞剂。偶尔会使用其他策略，但它们不是结构化方案的一部分。
制定心脏手术后房颤预防的综合内科和外科方案是术后心脏患者护理的一个重要方面。方案应考虑常规使用策略以外的预防策略。为了减少术后并发症和医疗成本，这一领域应受到相当的关注。
