Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama City, Wakayama, 641-8509, Japan.
Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, Wakayama City, Japan.
Surg Today. 2023 Oct;53(10):1139-1148. doi: 10.1007/s00595-023-02670-4. Epub 2023 Mar 9.
Atrial fibrillation (AF) frequently occurs after pulmonary resection and is commonly referred to as postoperative atrial fibrillation (POAF). This study explored whether or not POAF is related to the recurrence of AF in the chronic phase.
A total of 1311 consecutive patients without a history of AF who underwent lung resection based on a diagnosis of lung tumor were retrospectively analyzed.
POAF occurred in 46 patients (3.5%), and a logistic regression analysis revealed that the age (p < 0.05), history of hyperthyroidism (p < 0.05), and major lung resection (p < 0.05) were independent predictors of POAF. AF events in the chronic phase were observed in 15 (32.6%) and 45 (3.6%) patients with and without POAF, respectively. A Cox regression analysis revealed that POAF was the only independent predictor of AF development in the chronic phase (p < 0.01). The Kaplan-Meier curve and log-rank test revealed that the cumulative incidence of AF in the chronic phase was significantly higher in patients with POAF than in those without POAF (p < 0.01).
POAF was an independent predictor for AF in the chronic phase after lung resection. Further investigations including cases of catheter ablation and optimal medical therapy for patients with POAF after lung resection are needed.
肺切除术后常发生心房颤动(AF),通常称为术后心房颤动(POAF)。本研究探讨 POAF 是否与慢性期 AF 的复发有关。
回顾性分析了 1311 例连续无 AF 病史的患者,这些患者均根据肺部肿瘤的诊断进行了肺切除术。
46 例(3.5%)发生 POAF,逻辑回归分析显示,年龄(p<0.05)、甲状腺功能亢进症史(p<0.05)和大肺切除术(p<0.05)是 POAF 的独立预测因素。POAF 组和无 POAF 组分别有 15 例(32.6%)和 45 例(3.6%)患者发生慢性期 AF 事件。Cox 回归分析显示,POAF 是慢性期 AF 发展的唯一独立预测因素(p<0.01)。Kaplan-Meier 曲线和对数秩检验显示,POAF 组慢性期 AF 的累积发生率明显高于无 POAF 组(p<0.01)。
POAF 是肺切除术后慢性期 AF 的独立预测因素。需要进一步研究包括对肺切除术后 POAF 患者进行导管消融和最佳药物治疗的病例。