术后房颤：预防中风的靶点？
Postoperative atrial fibrillation: Target for stroke prevention?
作者信息
Thijs Vincent, Lemmens Robin, Farouque Omar, Donnan Geoffrey, Heidbuchel Hein
机构信息
Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia.
Department of Neurology, Austin Health, Heidelberg, Victoria, Australia.
出版信息
Eur Stroke J. 2017 Sep;2(3):222-228. doi: 10.1177/2396987317719363. Epub 2017 Jul 5.
PURPOSE
A substantial number of patients without a history of atrial fibrillation who undergo surgery develop one or more episodes of atrial fibrillation in the first few days after the operation. We studied whether postoperative transient atrial fibrillation is a risk factor for future atrial fibrillation, stroke and death.
METHOD
We performed a narrative review of the literature on epidemiology, mechanisms, risk of atrial fibrillation, stroke and death after postoperative atrial fibrillation. We reviewed antithrombotic guidelines on this topic and identified gaps in current management.
FINDINGS
Patients with postoperative atrial fibrillation are at high risk of developing atrial fibrillation in the long term. Mortality is also increased. Most, but not all observational studies report a higher risk of stroke. The optimal antithrombotic regimen for patients with postoperative atrial fibrillation has not been defined. The role of lifestyle changes and of surgical occlusion of the left atrial appendage in preventing adverse outcomes after postoperative atrial fibrillation is not established.
CONCLUSION
Further studies are warranted to establish the optimal strategy to prevent adverse long-term outcomes after transient, postoperative atrial fibrillation.
目的
大量无房颤病史的患者在接受手术后的头几天会发生一次或多次房颤发作。我们研究了术后短暂性房颤是否是未来发生房颤、中风和死亡的危险因素。
方法
我们对有关术后房颤的流行病学、机制、房颤风险、中风和死亡的文献进行了叙述性综述。我们查阅了关于该主题的抗栓指南，并确定了当前管理中的差距。
结果
术后房颤患者长期发生房颤的风险很高。死亡率也会增加。大多数（但不是所有）观察性研究报告中风风险更高。术后房颤患者的最佳抗栓方案尚未确定。生活方式改变和左心耳手术封堵在预防术后房颤不良结局中的作用尚未确立。
结论
有必要进行进一步研究，以确定预防术后短暂性房颤后不良长期结局的最佳策略。
Zotero 插件