Kawakami Atsushi, Kobayashi Yutaka, Katsube Takeshi
Department of Cardiovascular Surgery, Uji Tokushukai Medical Center, Uji, Japan.
Kyobu Geka. 2023 May;76(5):339-342.
Postoperative atrial fibrillation (POAF) after open heart surgery is common complication. POAF is reported to prolong hospital stay and increase long-term mortality, therefore prevention of POAF is important. It is widely known that beta blocker decrease POAF, and we had used oral beta blocker after open heart surgery. We examined the effect of intraoperative and postoperative administration of intravenous beta blocker( landiolol) for POAF.
We evaluated 291 consecutive patients who underwent open heart surgery from November 2016 to November 2018. Those who underwent open heart surgery after November 2017 were 145, and 100 of the patients( group A) had intraoperative and postoperative landiolol administration. Those who underwent open heart surgery before November 2017 were 146, and 100 of the patients (group B) did not have landiolol administration. The primary endpoint was incidence of POAF within 7 days after surgery.
There was no significant difference in preoperative character between the groups, other than the ratio of males to females( group A:54 males, 46 females;group B:68 males, 32 females;p<0.05). The incidences of POAF were 20% and 36% in group A and group B, respectively( p<0.05).
Intraoperative and postoperative administration of landiolol is effective for preventing POAF after open heart surgery.
心脏直视手术后的术后房颤(POAF)是一种常见并发症。据报道,POAF会延长住院时间并增加长期死亡率,因此预防POAF很重要。众所周知,β受体阻滞剂可降低POAF的发生率,我们曾在心脏直视手术后使用口服β受体阻滞剂。我们研究了术中及术后静脉注射β受体阻滞剂(兰地洛尔)对POAF的影响。
我们评估了2016年11月至2018年11月期间连续接受心脏直视手术的291例患者。2017年11月后接受心脏直视手术的患者有145例,其中100例患者(A组)在术中及术后使用了兰地洛尔。2017年11月前接受心脏直视手术的患者有146例,其中100例患者(B组)未使用兰地洛尔。主要终点是术后7天内POAF的发生率。
除男女比例外(A组:54例男性,46例女性;B组:68例男性,32例女性;p<0.05),两组术前特征无显著差异。A组和B组的POAF发生率分别为20%和36%(p<0.05)。
术中及术后使用兰地洛尔对预防心脏直视手术后的POAF有效。