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Updated: Mar 18, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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在外科手术左前庭尾闭塞和CABG后发生性前庭动/动的抗凝药

Vivek Bhat¹, Bharat Rawlley², Kartik Gupta³

¹Division of Cardiology, Department of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.

Pacing and clinical electrophysiology : PACE

|March 17, 2026

概括

在外科手术左心房附属物阻塞 (sLAAO) 后与冠状动脉旁路移植 (CABG) 进行抗凝治疗,并没有降低患有新心房动/心房动 (AF/AFL) 的患者中风或死亡风险. 它显著增加了严重出血的风险.

科学领域:

心脏病学心脏病学
心脏外科手术心脏外科手术
血管外科血管外科

背景情况:

手术左心房尾闭塞 (sLAAO) 用于降低心房动 (AF) 患者中风风险.
在冠状动脉旁路移植 (CABG) 中使用sLAAO的预防作用以及在CABG-sLAAO后新发AF/心房 (AF/AFL) 的患者中抗凝剂的作用尚不清楚.

研究的目的:

在接受CABG-sLAAO后发展新的AF/AFL的患者中,比较抗凝药与不使用抗凝药的结果.
为了评估这种患者队列中缺血性中风,严重出血和全因死亡率的风险.

主要方法:

使用TrinetX数据库的回顾性分析确定了先前有CABG-sLAAO的患者,他们发展了新的AF/AFL.
患者被分为抗凝剂组和没有抗凝剂组.
使用倾向分数匹配 (PSM) 来平衡基线特征,然后进行结果评估.

主要成果:

在PSM之后,分析了451对患者. 两组之间不存在缺血性中风风险 (9.3%与7.3%) 或所有原因死亡率 (9.6%与11.2%) 的显著差异.
然而,抗凝剂组的严重出血风险显著增加 (10.6%对5.2%).

结论:

在CABG-sLAAO后发展新的AF/AFL的患者中,抗凝药与中风或死亡率的降低无关.
抗凝药在这种特定患者群体中显著增加重大出血的风险.
结果表明抗凝剂的增量益处有限,并强调需要进行前性研究.

关键词:

在 DOAC 系统中使用 DOAC.心房附属体的闭塞,心房附属体的闭塞.在心房心律不整的情况下.心脏外科手术的心脏手术作为XA因子抑制剂的使用.预防中风预防中风

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