Bagheri Reza, Yousefi Yousef, Rezai Reza, Azemonfar Vahab, Keshtan Farideh Golhasani
Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Student Research Committee, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
Kardiochir Torakochirurgia Pol. 2019 Jul;16(2):53-56. doi: 10.5114/kitp.2019.86355. Epub 2019 Jun 28.
Cardiac complications are the second most common cause of morbidity and mortality in patients subjected to thoracic surgery after respiratory complications. Postoperative arrhythmia is one of the most common cardiac complications in these patients. It leads to morbidity, increased hospitalization, and high costs for patients.
To determine the incidence of atrial fibrillation after lung resection and determine the underlying factors and predictors of this problem.
The participants in this study were composed of all patients who were subjected to lung resection surgery in the past 4 years. The demographic data of the patients and possible postoperative complications, including the incidence of atrial fibrillation, were extracted from patient records. The statistical analysis of data was performed after data collection.
The incidence of postoperative atrial fibrillation (POAF) in the present study was 7.6% ( = 20), mostly in patients who had a lung parenchyma resection. It occurred due to malignancy ( = 16), squamous cell carcinoma ( = 9), adenoid cystic carcinoma ( = 5), and metastasis ( = 2). The POAF occurred in 34.2% of pneumonectomy cases and 4.5% of lobectomy cases, out of whom 60% were male. There was a significant difference between the two groups of arrhythmia and non-arrhythmia groups regarding the age range. The mean ages of patients with and without arrhythmias were 56.45 ±18.2 and 44.76 ±17.2, respectively.
Pulmonary malignant pathologies are more likely to develop POAF due to the need for lung resection and possibly mediastinal lymphadenectomy that stimulates the heart and pericardium and the vagus nerve.
心脏并发症是胸外科手术后患者发病和死亡的第二大常见原因，仅次于呼吸并发症。术后心律失常是这些患者最常见的心脏并发症之一，会导致发病、住院时间延长以及患者费用增加。
确定肺切除术后房颤的发生率，并确定该问题的潜在因素和预测指标。
本研究的参与者包括过去4年中接受肺切除手术的所有患者。从患者记录中提取患者的人口统计学数据以及可能的术后并发症，包括房颤的发生率。数据收集后进行统计分析。
本研究中术后房颤（POAF）的发生率为7.6%（n = 20），主要发生在肺实质切除的患者中。其发生原因包括恶性肿瘤（n = 16）、鳞状细胞癌（n = 9）、腺样囊性癌（n = 5）和转移瘤（n = 2）。全肺切除病例中POAF发生率为34.2%，肺叶切除病例中为4.5%，其中60%为男性。心律失常组和非心律失常组在年龄范围上存在显著差异。有心律失常和无心律失常患者的平均年龄分别为56.45±18.2岁和44.76±17.2岁。
由于需要进行肺切除以及可能的纵隔淋巴结清扫术刺激心脏、心包和迷走神经，肺部恶性病变更易发生POAF。
