在荷兰心胸中心预防术后心房动的干预措施:一项调查研究
Angelique Emiola1, Jolanda Kluin2, Sulayman El Mathari1
1Department of Cardiothoracic Surgery, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
概括
荷兰心胸中心报告了类似的术后心房动 (POAF) 率,尽管预防策略不同. 预防性阿米奥达龙,科尔奇辛和POAF的外科手术方法未得到充分利用,这表明需要遵守指南.
科学领域:
- 心脏病学 心脏病学
- 胸部外科手术 胸部外科手术
- 临床实践 临床实践
背景情况:
- 手术后心房动 (POAF) 是心脏手术后的常见并发症.
- 目前的预防策略及其与国际准则的协调需要评估.
研究的目的:
- 评估荷兰心胸中心当前的POAF预防策略.
- 确定常见的做法,并将其与国际建议进行比较.
主要方法:
- 一份在线问卷分发给所有荷兰心胸外科中心.
- 该调查涵盖了药物 (β-阻断剂,抗体) 和非药物 (心周切除术,冲洗,肉毒毒素) 预防POAF的方法.
- 调查还包括电动心脏转换,抗凝剂和左心房附属体关闭.
主要成果:
- 在15个中心中,有14个响应,其中13个报告POAF发生率在20-30%之间.
- 6个中心使用了手术前的AF预防,主要是非sotalolβ-阻断剂 (57%).
- 手术后的药物包括非索塔醇β-阻断剂 (38%),索塔醇 (24%),和阿米奥达龙 (10%). 术术策略,如心周切除术是最小的使用 (2中心).
结论:
- 尽管采取了不同的预防方法,但POAF发病率在荷兰中心仍然相似.
- 与指导方针建议相反,阿米奥达龙和菌素的预防性使用有限.
- 对预防POAF的外科手术策略的实施受到限制.
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