Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Ann Card Anaesth. 2021 Oct-Dec;24(4):464-469. doi: 10.4103/aca.ACA_30_20.
Atrial fibrillation in postoperative period is common. Although the event of atrial fibrillation is associated with reduced cardiac output and its consequences and cerebrovascular events, its effect on outcome is not clearly documented. This study is done to evaluate the effect of atrial fibrillation on outcome of the operation.
This is a retrospective case-control study. A total of 263 patients received coronary artery bypass grafting during this period. The data for demographics, comorbidities, preoperative medications, operative details, and echocardiographic parameters of left ventricular functions were acquired. A total of 24 patients had atrial fibrillation (Group I), while 239 remained in normal sinus rhythm (Group II). The outcome is measured as combined of death and postoperative myocardial infarction (MI).
The groups are comparable in demographic, preoperative medications, operative, and left ventricular parameters. Of the 24 (9.12%) patients who had postoperative atrial fibrillation, 11 were discharged on medical management. Nine patients reverted to sinus rhythm at discharge. Atrial fibrillation persisted in 8 patients 1 week after discharge and 3 patients after 1 month. The requirement of intraaortic balloon pump (IABP) was statistically significant in group I (5 in group I vs. 10 in group II, n = 0.001). There were 4 deaths in group 1 and 7 in group 2 (P = 0.002), however, the combined end point was achieved in 4 (16.6%) vs. 22 (9.2%), respectively, P = 0.1.
The appearance of atrial fibrillation heralds increased requirement of IABP, MI, and death in patients undergoing coronary artery bypass grafting.
术后心房颤动很常见。尽管心房颤动的发生与心输出量减少及其后果和脑血管事件有关，但它对结局的影响尚未明确记录。本研究旨在评估心房颤动对手术结局的影响。
这是一项回顾性病例对照研究。在此期间，共有 263 名患者接受了冠状动脉旁路移植术。获得了人口统计学、合并症、术前用药、手术细节以及左心室功能超声心动图参数的数据。共有 24 例患者发生心房颤动（I 组），而 239 例患者保持窦性心律（II 组）。结果以死亡和术后心肌梗死（MI）的组合来衡量。
两组在人口统计学、术前用药、手术和左心室参数方面具有可比性。在 24 例（9.12%）术后发生心房颤动的患者中，有 11 例接受药物治疗出院。9 例患者在出院时恢复窦性心律。8 例患者在出院后 1 周和 3 例患者在出院后 1 个月仍持续心房颤动。I 组的主动脉内球囊泵（IABP）需求具有统计学意义（I 组 5 例，II 组 10 例，n=0.001）。I 组有 4 例死亡，II 组有 7 例死亡（P=0.002），但联合终点分别为 4 例（16.6%）和 22 例（9.2%），P=0.1。
在接受冠状动脉旁路移植术的患者中，心房颤动的出现预示着需要更多的 IABP、MI 和死亡。
