心电图和心房尾多普勒异调在接受心脏手术的患者中很常见:前性研究
Akiva Nachshon1, Qizhe Cai2,3, Jason D Matos2
1Department of Anesthesia, Harvard Medical School, Boston, Massachusetts, USA.
JACC. Advances
|August 12, 2024
概括
有相当数量的心脏手术患者没有心房 (AF) 史,表现出心电图和心房附属体节律之间的不一致. 这种异常可能会增加非抗凝血患者的血栓栓塞的风险.
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:
- 患有心房的患者面临高血栓栓塞的风险,即使有明显的鼻节律,由于潜在的无症状心房发作.
- 心房机械失调,左心房 (LA) 处于鼻腔节律,左心房附属体 (LAA) 处于AF,可能会导致这种风险.
研究的目的:
- 为了确定心电图 (ECG) 节律与LAA/右心房附属体 (RAA) 多普勒喷射现型 (过食管心声[TEE]) 之间的异调频率.
- 在接受心脏手术的患者中评估这种异常.
主要方法:
- 124名接受冠状动脉旁路移植 (CABG) 或门手术的患者进行了前性研究.
- 在心肺旁路术之前进行了手术内心电图和TEE.
- 脑电图和TEE LAA/RAA多普勒光谱被独立分类为鼻节律或AF.
主要成果:
- 在没有先前AF病史的107名患者中,有39名 (36%) 患有心电图/心房附带多普勒异常.
- 具体来说,12%的人有ECG/LAA不一致,33%的人有ECG/RAA不一致.
- 在一致和不一致的组之间没有发现年龄,性别或并发症的显著差异.
结论:
- 显著的少数心脏手术患者没有AF病史,表现出心电图/心房附属体多普勒异调.
- 这种异常可能会增加不接受抗凝药的患者血栓栓塞的风险.
- 临床参数不能可靠地识别患有这种不一致性风险增加的患者.
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