Incidence, timing, symptoms, and risk factors for atrial fibrillation after cardiac surgery
Incidence, timing, symptoms, and risk factors for atrial fibrillation after cardiac surgery
复制标题
DOI：
10.4037/ajcc2003.12.5.424
复制
发表时间：
2003-09-01
影响因子：
2.7
通讯作者：
Wilcox, H
中科院分区：
文献类型：
--
作者：
Funk, M;Richards, SB;Wilcox, H
试验性纤维性颤动是心脏手术后最常见的并发症，也是发病率和护理费用增加的主要原因。方法对302例冠状动脉旁路移植术后患者在住院期间使用标准硬线和遥测设备连续监测房颤，并与心脏手术后房颤的危险因素进行比较。或瓣膜手术，并在出院后2周内使用可穿戴心脏事件记录仪。出院后，患者记录并通过电话传输他们的节奏，每天，每当他们有症状提示房颤fibrillation.Results的302例患者，127（42%）有房颤，41出院后，10这是他们的第一次发作。首次发作发生在术后平均2.9天（SD，3.1;范围，手术当天至术后21天）。虽然心悸是最常见的症状（17%），但大多数房颤发作（69%）与症状无关。房颤的独立预测因素为年龄≥ 65岁、有间歇性房颤病史、心房起搏、男性、白色人种和无高脂血症。出院后心房颤动的独立预测因素有心房颤动，而住院，瓣膜手术，肺动脉高压。结论心房颤动是常见的心脏手术后，往往发生在出院后，没有伴随症状。对于具有房颤风险增加特征的患者，可能需要进行门诊监测。
BACKGROUND A trial fibrillation is the most common complication after cardiac surgery and a major cause of morbidity and increased cost of care.OBJECTIVES To examine the incidence, timing, symptoms, and risk factors for atrial fibrillation after cardiac surgery.METHODs A total of 302 patients were continuously monitored for atrial fibrillation with standard hardwire and telemetry devices during hospitalization after coronary artery bypass graft and/or valve surgery and with wearable cardiac event recorders for 2 weeks after discharge from the hospital. After discharge, patients recorded and transmitted their rhythm by telephone daily and whenever they had symptoms suggestive of atrial fibrillation.RESULTS of the 302 patients, 127 (42%) had atrial fibrillation; 41 had it after discharge, and for 10 it was their first episode. The first episode occurred at a mean of 2.9 days after surgery (SD, 3.1; range, day of surgery to 21 days after surgery). Although palpitations was the most common symptom (17%), most episodes of atrial fibrillation (69%) were not associated with symptoms. Independent predictors of atrial fibrillation were age 65 years or greater history of intermittent atrial fibrillation, atrial pacing, male sex, white race, and not having hyperlipidemia. Independent predictors of atrial fibrillation after discharge from the hospital were having atrial fibrillation while hospitalized, valve surgery, and pulmonary hypertension.CONCLUSIONS Atrial fibrillation is common after cardiac surgery and often occurs after discharge from the hospital and without accompanying symptoms. Outpatient monitoring may be warranted in patients with characteristics that place them at increased risk for atrial fibrillation.