迷路手術後の心房タキアリズム:発生率と予後
Yosuke Ishii1, Marye J Gleva, M Carolyn Gamache
1Washington University School of Medicine, Division of Cardiothoracic Surgery, St. Louis, Mo, USA.
Circulation
|September 15, 2004
まとめ
アトリアルタキアリズム (ATA) は,マゼ手術後の患者の43%に影響し,通常は8日以内に発生し,3週間以内に回復します. 早期のATAは,遅期の心房細動の再発を予測するものではありません.
科学分野:
- 心臓外科手術について
- 電気生理学 電気生理学
- アリトモロジー アリトモロジー
背景:
- 迷宮処置は,正常な副鼻腔リズムを回復するのに有効です.
- アトリヤ・タキアリズム (ATA) は,迷宮手術後の早期合併症として頻繁に見られる.
- 迷宮後のATAの発生率と自然史を理解することは極めて重要です.
研究 の 目的:
- 迷宮術後の早期の術後ATAの発生率を決定する.
- ATAの自然史と解像度パターンを記述する.
- 早期のATAと遅期の心房動の再発の関係について調査する.
主な方法:
- 1987年から2002年にかけて,マレーズ処置 (I,II,III) を受けた200人の患者の医療記録の遡及的レビュー.
- 手術後30日以内に発生したすべての早期の術後ATAエピソードの分析.
- 2人の電気生理学者による術後の12鉛電心電図の独立したレビュー.
主要な成果:
- ATAは86人の患者 (43%),心房細動 (AF) は59%,心房 (AFL) は14%,両方が27%で発生しました.
- ATAのピーク発生は術後8日目であり,平均期間は5.7日でした.
- 遅いAF再発 (>1年) は,早期ATA (7.0%対8.8%,P=0.8) の患者と早期ATAの患者との間に有意な違いを示さなかった.
結論:
- 早期の術後のATAは,メーゼの手術後に一般的 (43%),主に8日以内に発生します.
- ほとんどのATAエピソードは,約3週間以内に解消します.
- 早期の術後のATAの存在は,心房細動の遅い再発と相関していません.
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