心脏手术后的术后心房动 (POAF):临床实践审查
Orlando R Suero1, Ahmed K Ali2, Lauren R Barron2,3
1Divisions of Cardiovascular Anesthesia & Critical Care Medicine, Department of Anesthesiology, Baylor College of Medicine, Houston, TX, USA.
Journal of thoracic disease
|March 20, 2024
概括
心脏手术后的术后心房动 (POAF) 可以通过外科手术期间的干预措施来减少. 个性化抗凝决定是管理POAF及其相关风险的关键.
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:
- 手术后心房动 (POAF) 是心脏手术后的常见并发症,增加了患者的发病率和死亡率.
- 目前对POAF的预测模型的准确性有限,需要改进风险缓解策略.
研究的目的:
- 审查和综合当前关于预防和管理POAF的外科手术期间干预措施的证据.
- 讨论手术前,手术内和手术后策略在减少POAF发生率和影响方面的作用.
主要方法:
- 审查关于POAF预防和治疗的现有文献.
- 对药理和程序干预的分析.
- 讨论抗凝固策略和新兴技术.
主要成果:
- 手术前的药物 (β阻塞剂,阿米奥达龙) 和对心房的查至关重要.
- 在手术期间采取的措施,如后心膜切除术和术后开始服用药物,可以降低POAF风险.
- 速率控制和节律控制策略对已建立的POAF显示了可比的结果;由于中风风险较低和出血潜力较高,抗凝血决定需要个性化.
结论:
- 一个全面的,多方面的方法,涉及手术前,手术内和手术后的干预,对于POAF管理至关重要.
- 为POAF患者推个性化抗凝策略,考虑到他们独特的风险概况.
- 像可穿戴设备和机器学习这样的新兴技术对未来的POAF预测和管理充满希望.
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