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心脏手术后心房颤动的机制、预防和治疗:叙述性综述。

Mechanisms, Prevention, and Treatment of Atrial Fibrillation After Cardiac Surgery: A Narrative Review.

机构信息

Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium; Department of Intensive Care Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium.

Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium; Department of Intensive Care Medicine, OLVG-Hospital, Amsterdam, The Netherlands.

出版信息

J Cardiothorac Vasc Anesth. 2021 Nov;35(11):3394-3403. doi: 10.1053/j.jvca.2020.11.030. Epub 2020 Nov 19.

Abstract

New onset of postoperative atrial fibrillation (AF) generally is recognized as a frequent and debilitating complication after cardiac surgery, contributing to a considerable health- care cost. Extensive research has been conducted to study the underlying mechanisms and risk factors of AF in the perioperative period. Many options have been suggested to lower the incidence, and the concurrent cost in health resources. This review attempts to synthesize the large body of existing literature on AF, as well as expand and illustrate the available knowledge on its management strategies. The latter incorporates recent developments in the anesthesthetic approach as well as in the pharmacologic arsenal. In addition, the current review provides a tool for understanding the pathophysiology of AF and for reducing the occurrence after cardiac surgery. By using it, clinicians can manage patients with AF in the perioperative period of cardiac surgery and minimize the relatively high economic cost that accompanies it.

摘要

术后心房颤动(AF)的新发病例通常被认为是心脏手术后常见且使人虚弱的并发症,导致相当大的医疗保健费用。已经进行了广泛的研究来研究围手术期 AF 的潜在机制和危险因素。已经提出了许多选择来降低发病率,并降低同期的卫生资源成本。本综述试图综合大量现有的关于 AF 的文献,并扩展和说明其管理策略的现有知识。后者包含了麻醉方法以及药理学武器库的最新进展。此外,本综述还提供了一种工具,用于了解 AF 的病理生理学,并减少心脏手术后的发生。通过使用它,临床医生可以在心脏手术的围手术期管理 AF 患者,并最大限度地降低其伴随的相对较高的经济成本。

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