冠状动脉旁路移植术后心房颤动及治疗

为探讨冠状动脉旁路移植 (CABG)术后早期心房颤动 (AF)的易患危险因素 ,回顾分析 81例单纯CABG病人的年龄、合并症、左房和左室大小、术前心功能、手术方式、血管桥数目及术后并发症等因素与术后AF发生的关系 ,并总结药物及电复律转复AF的效果。结果 :术后早期AF发生率为 2 3.5 % ,AF病人术后ICU监护时间延长 ;单因素分析表明高龄 (≥ 6 5岁 )、移植血管桥数目及术后并发症与AF发生密切相关 (P =0 .0 1,0 .0 0 2 ,0 .0 0 1)。Logistic回归表明术后并发症是AF发生的独立危险因素。 (P =0 .0 0 9,B =1.73,OR值为 5 .6 5 )AF总转复率为 81.3% ,电转复 2例 ,药物转复 11例 (78.6 % )。结论 :增龄、移植血管桥数目增多及出现术后并发症是CABG术后早期AF的易患危险因素 ,药物及电复律能有效转复术后AF。

Predictors and treatment of Atrial Fibrillation Following Coronary Artery Bypass Grafting Surgery

To investigate the incidence and clinical predictors of atrial fibrillation (AF) after coronary artery bypass grafting(CABG) and discuss its treatment. Eighty-one patients underwent isolated CABG procedure were reviewed and were grouped according to whether AF appeared. Preoperative data, type of grafting, number of grafts and postoperative complications were analysed with statistic methods to identify the predictors of postoperative AF. Patients with AF were treated with medication or electrical cardioversion. Results: The overall incidence of postoperative AF was 23.5%(19/81), Postoperative AF was close related to age≥65,number of grafts and postoperative complication. Logistic regression indicated that postoperative complication was the independent predictor( P =0.009,B=1.73,OR=5.65). Conversion to sinus rhythm rate of postoperative AF was 81.3%, two patients conversed to sinus rhythm with electrical cardioversion and 11 patients (78.6%) with drugs. Conclusion: Advanced age, number of grafts and postoperative complications can influence the incidence of postoperative AF. Medication and electrical conversion were effective for the treatment of AF after CABG.