迷宫手术后的心房动脉节律障碍:发生率和预后
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
概括
耳前动脉节律不良 (ATA) 影响43%的 Maze 术后患者,通常发生在8天内,并在3周内消失. 早期的ATA不能预测晚期心房的复发.
科学领域:
- 心脏外科手术 心脏外科手术
- 电子生理学 电子生理学
- 节律失常学 节律失常学
背景情况:
- 迷宫手术对于恢复正常的鼻节律是有效的.
- 耳前动脉节律不良 (ATA) 是迷宫手术后常见的早期并发症.
- 了解ATA的发病率和迷宫后的自然历史至关重要.
研究的目的:
- 为了确定迷宫手术后早期术后ATA的发生率.
- 描述ATA的自然历史和分辨率模式.
- 调查早期ATA和晚期心房动复发之间的关系.
主要方法:
- 从1987年到2002年,对200名接受迷宫手术 (I,II,III) 的患者的病历进行了回顾性审查.
- 对手术后30天内所有早期术后ATA发作进行分析.
- 两个电生理学家对手术后的12导电心电图进行了独立审查.
主要成果:
- ATA发生在86名患者 (43%),心房动 (AF) 在59%,心房动 (AFL) 在14%,两者在27%.
- ATA的峰值发生在术后8天;平均持续时间为5.7天.
- 晚期AF复发 (>1年) 在患有或没有早期ATA的患者之间没有显著差异 (7.0%与8.8%,P=0.8).
结论:
- 在迷宫手术后,早期的术后ATA很常见 (43%),主要发生在8天内.
- 大多数ATA发作在大约3周内消失.
- 早期术后ATA的存在与心房的晚期复发无关.
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