Atrial Arrhythmias After Lung Transplantation: Epidemiology, Mechanisms at Electrophysiology Study, and Outcomes
Atrial Arrhythmias After Lung Transplantation: Epidemiology, Mechanisms at Electrophysiology Study, and Outcomes
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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：
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
B. Koplan
中科院分区：
文献类型：
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作者：
Vincent Y. See;K. Roberts‐Thomson;W. Stevenson;P. Camp;B. Koplan
房性心律失常（AAs）包括心房颤动（AF）和房性心动过速（AT）是心胸外科手术后常见的并发症。我们的目的是评估肺移植后AA的患病率和机制。方法和结果-所有在我们中心随访超过20年的双侧序贯肺移植患者（n=127）都包括在内。所有患者在术后1、3、6和12个月或根据需要接受心律监测和ECG门诊访视。40/127例（31.5%）患者在4.2±4.1年内发生AA。术后1、3、6、12和>12个月的AA患病率分别为24%、11%、3%、2%、4%和11%。早期AA主要为AF，而所有>12个月的AA均为AT。至首次AF的时间与至首次AT的时间分别为11±9天和1485±2462天（P=0.09）。男性性别、年龄和术前AA可预测任何早期（<3个月）AA，但不能预测晚期AA。早期AA不能预测晚期AT。在4例耐药房速患者中，电生理检查发现3例房速累及肺静脉/左心房，其中1例为供体-受体传导，2例为边界区大折返，1例为三尖瓣环峡部依赖性扑动;所有患者均成功消融。结论：肺移植术后AA是常见的。虽然房颤在早期很常见，但在左心房切口愈合后房颤很少见，这可能导致手术肺静脉隔离，但极少数例外。这就提出了一个问题，即肺移植时额外的手术或消融线是否可以预防晚期AA。
Background—Atrial arrhythmias (AAs) including atrial fibrillation (AF) and atrial tachycardia (AT) are often observed after cardiothoracic surgery. Our aim was to evaluate the prevalence and mechanism of AAs after lung transplantation. Methods and Results—All patients (n=127) after bilateral sequential lung transplantation followed at our institution over 20 years were included. All patients received postoperative rhythm monitoring and clinic visits with ECG at 1, 3, 6, and 12 months, or as needed. AAs occurred in 40 of 127 (31.5%) patients over 4.2±4.1 years. AA prevalence at postoperation and 1, 3, 6, 12, and >12 months was 24%, 11%, 3%, 2%, 4%, and 11%, respectively. Early AAs were predominantly AF, whereas all AAs >12 months were AT. Time to first AF versus AT was 11±9 versus 1485±2462 days (P=0.09). Male sex, age, and preoperative AA predicted any early (<3 months) AA but did not predict late AA. Early AA did not predict late AT. In 4 patients with drug-resistant AT, electrophysiology studies found AT involving the pulmonary vein/left atrium anastomoses in 3 patients, including donor-to-recipient conduction in 1, border zone macroreentry in 2, and cavotricuspid isthmus dependent flutter in 1; all patients were successfully treated with ablation. Conclusions—AAs after lung transplantation are common. Although AF is common early, AF is rare after healing of left atrial incisions, which probably result in surgical pulmonary vein isolation with rare exception. This raises the question of whether additional surgical or ablation lines at the time of lung transplantation would prevent late AA.
影响因子：
24
作者：
Vaseghi,Marmar;Boyle,NoelG;Kedia,Rohit;Patel,JigneshK;Cesario,DavidA;Wiener,Isaac;Kobashigawa,JonA;Shivkumar,Kalyanam
通讯作者：
Shivkumar,Kalyanam
左侧心房扑动：急性犬模型中小儿肺移植的新并发症的特征。
DOI：
10.1016/s0022-5223(96)70100-9
发表时间：
1996
期刊：
The Journal of thoracic and cardiovascular surgery.
影响因子：
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作者：
Gandhi,SK;Bromberg,BI;Schuessler,RB;Boineau,JP;Cox,JL;Huddleston,CB
通讯作者：
Huddleston,CB