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随机对照性研究调查了在冠状动脉旁路移植后,心房节奏在预防心房的效果.

T Levy1, G Fotopoulos, S Walker

  • 1Department of Cardiac Surgery, Royal Brompton and Harefield NHS Trust, Harefield Hospital, Harefield, Middlesex, UK. terry@levy77.freeserve.co.uk

Circulation
|September 20, 2000
PubMed
概括

在冠状动脉旁路移植 (CABG) 后,双心脏节奏显著降低了心房动 (AF). 这种方法还降低了术后并发症,为药物治疗提供了有希望的替代方案.

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科学领域:

  • 心脏病学 心脏病学
  • 心脏外科手术 心脏外科手术
  • 电子生理学 电子生理学

背景情况:

  • 心房动 (AF) 是冠状动脉旁路移植 (CABG) 后的常见并发症.
  • 目前针对CABG AF后的预防性药物治疗已显示出有限的疗效.
  • 需要采取替代的预防策略,以减轻CABG后的AF发病率.

研究的目的:

  • 为了评估双心节奏在隔离首次CABG后预防AF的有效性.
  • 为了比较接受双心节律调节的患者与没有接受节律调节的患者的AF发病率.

主要方法:

  • 在手术期间,临时的节奏导线被放置在右心室和左心室 (巴赫曼捆) 中.
  • 在手术后,患者随机分配到4天的双心节奏 (80bpm) 或没有节奏 (对照组,30bpm).
  • 终点包括监测和临床检测的AF发作,ICU/住院和并发症.

主要成果:

  • 双心节奏显著减少了监测的AF发作 (13.8%对38.5%,P=0.001) 和临床AF发作 (10.8%对33.8%,P=0.002).
  • 术后并发症的发生率在双心节奏组 (13对35,P=0.001) 中明显较低.
  • 两组之间在ICU或住院时间方面没有发现显著差异.

结论:

  • 双心节奏是降低CABG后AF发病率的有效策略.
  • 这种节奏方法与手术后并发症的减少有关.
  • 双心节奏显示了在CABG后减少ICU和住院的趋势.