Incidence, Risk Factors, Prognosis, and Electrophysiological Mechanisms of Atrial Arrhythmias after Lung Transplantation.
Incidence, Risk Factors, Prognosis, and Electrophysiological Mechanisms of Atrial Arrhythmias after Lung Transplantation.
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肺移植术后房性心律失常的发生率、危险因素、预后和电生理机制。
DOI：
10.1016/j.jacep.2015.05.009
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Valderrábano,Miguel
中科院分区：
文献类型：
--
作者：
Chaikriangkrai,Kongkiat;Jyothula,Soma;Jhun,HyeYeon;Chang,SuMin;Graviss,EdwardA;Shuraih,Mossaab;Rami,TapanG;Dave,AmishS;Valderrábano,Miguel
目的 本研究的目的是探讨肺移植后房性心律失常 (AA) 的发生率和时机、危险因素、预后意义和电生理机制。 背景 尽管新发 AA 在胸外科手术后很常见，并且与较差的预后相关，但肺移植人群中的预后和机制数据很少。 方法对总共 293 名连续分离的不知道 AA 的肺移植受者进行回顾性分析。平均随访时间为 28 ± 17 个月。对 25 名 AA 患者进行了电生理学研究 (EPS)。结果肺移植后新发 AA 的发生率最高发生在移植后 30 天内（占所有患者的 25%）。在多变量分析中，术后 AA 与双肺移植（优势比：2.79；p = 0.005）和较低的平均肺动脉压（优势比：0.95；p = 0.027）相关。术后 AA 患者的住院时间更长（21 天 vs. 12 天；p < 0.001）。术后 AA 与晚期 AA 独立相关（风险比：13.52；p < 0.001），但与死亡率无关（风险比：1.55；p = 0.14）。 EPS 中，有 14 名患者仅患有心房扑动，11 名患者患有心房扑动和颤动。在所有 EPS 患者中，20 例（80%）有多种 AA 机制，包括三尖瓣周围扑动（48%）、二尖瓣周围扑动（36%）、右心房切口折返（24%）、受者肺静脉（PV）窦局灶性心动过速（32%）、局灶性 PV 颤动（24%）和左心房顶扑动（20%）。 80% 的 EPS 患者（25 名中的 20 名）存在左心房机制，且起源于 PV 窦部吻合。结论 术后 AA 与较长住院时间和晚期 AA 独立相关，但与死亡率无关。来自自体PV窦的多形性PV窦性心律失常是肺移植后AA的主要原因。
ObjectivesThe purpose of this study was to investigate the incidence and timing, risk factors, prognostic significance, and electrophysiological mechanisms of atrial arrhythmia (AA) after lung transplantation.BackgroundAlthough new-onset AA is common after thoracic surgery and is associated with poorer outcomes, prognostic and mechanistic data are sparse in lung transplant populations.MethodsA total of 293 consecutive isolated lung transplant recipients without known AA were reviewed retrospectively. Mean follow-up was 28 ± 17 months. Electrophysiology studies (EPS) were performed in 25 patients with AA.ResultsThe highest incidence of new-onset AA after lung transplantation occurred within 30 days after transplantation (25% of all patients). In multivariable analysis, post-operative AA was associated with double-lung transplantation (odds ratio: 2.79; p = 0.005) and lower mean pulmonary artery pressure (odds ratio: 0.95; p = 0.027). Patients with post-operative AA had longer hospital stays (21 days vs. 12 days; p < 0.001). Post-operative AA was independently associated with late AA (hazard ratio: 13.52; p < 0.001) but not mortality (hazard ratio: 1.55; p = 0.14). On EPS, there were 14 patients with atrial flutter alone and 11 with atrial flutter and fibrillation. Among all EPS patients, 20 (80%) had multiple AA mechanisms, including peritricuspid flutter (48%), perimitral flutter (36%), right atrial incisional re-entry (24%), focal tachycardia from recipient pulmonary vein (PV) antrum (32%), focal PV fibrillation (24%), and left atrial roof flutter (20%). Left atrial mechanisms were present in 80% of EPS patients (20 of 25) and originated from the anastomotic PV antrum.ConclusionsPost-operative AA was independently associated with longer length of stay and late AA but not mortality. Pleomorphic PV antral arrhythmogenesis from native PV antrum is the main cause of AA after lung transplantation.
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影响因子：
2.8
作者：
P. Azadani;U. Kumar;Yanfei Yang;M. Scheinman;C. Hoopes;G. Marcus;C. Rifkin;J. Olgin;Byron K. Lee
通讯作者：
Byron K. Lee
影响因子：
0.9
作者：
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通讯作者：
B. Vidne
心房传导导管消融可治疗原位心脏移植后的房性心律失常。
影响因子：
24
作者：
N. Saoudi;M. Redonnet;F. Anselme;H. Poty;A. Cribier
通讯作者：
A. Cribier
肺移植后房性心律失常：流行病学、电生理学研究机制和结果
DOI：
--
发表时间：
2009
期刊：
Circulation: Arrhythmia and Electrophysiology
影响因子：
--
作者：
Vincent Y. See;K. Roberts‐Thomson;W. Stevenson;P. Camp;B. Koplan
通讯作者：
B. Koplan
肺动脉收缩压升高与肺移植后房颤风险降低相关。
影响因子：
1.3
作者：
Malik,Anuj;Hsu,JonathanC;Hoopes,Charles;Itinarelli,Gina;Marcus,GregoryM
通讯作者：
Marcus,GregoryM