Research on the mechanism and management of atrial fibrillation after MIDCAB, OPCAB surgery

心房颤动（af）是冠状动脉搭桥术后常见的并发症，但对微创冠状动脉搭桥术（MIDCAB）和非体外循环冠状动脉搭桥术（OPCAB）的了解甚少。为了确定搏动后冠状动脉搭桥的预测因子，使用SPSS对MIDCAB （N=138）和OPCAB （N=129）患者进行了多重分析。术后发生房颤59例（22.1%）。多因素预测因素为术前合并糖尿病（CR4.844, 95%CI 2.356 ~ 9.958, p=0.000）、术前肾功能衰竭（CR2.845, 95%CI 1.176 ~ 6.884, p=0.002）、右冠状动脉旁路移植术（cr3.540, 95%CI 1.020 ~ 12.279, p=0.046）。低左室射血分数和术前使用钙拮抗剂均有较高倾向。2)搏动冠状动脉手术期间进行电生理作图研究。然而，心房颤动没有发展，也没有获得心房颤动的资料。窦性心律期间，心房、SVC和肺静脉均无异常电位。研制了心外膜心外膜标测计算机分析系统。使用快速傅立叶变换的频谱分析对检查周期长度是有用的。3)为了阐明自发性心房颤动的机理，采用快速傅立叶变换分析Holter EGG。波谱分析表明，心房纤颤的自发终止可能取决于纤颤波的组织，药物诱导的心房纤颤终止可能取决于心房纤颤的组织。

Atrial fibrillation (af) is frequent complication after coronary artery bypass surgery, but little was known after minimally invasive coronary artery bypass (MIDCAB) and off-pump coronary artery bypass (OPCAB).To determine the predictor of af after beating coronary artery bypass, multianalysis was performed using SPSS in MIDCAB (N=138) and OPCAB (N=129) patients. Postoperative af developed in 59 patients(22.1%).Multivariate predictors were preoperative combination of diabetes mellitus (CR4.844, 95%CI 2.356-9.958, p=0.000), preoperative renal failure (CR2.845, 95%CI 1.176-6.884, p=0.002) and bypass graft for right coronary artery (CR 3.540, 95%CI 1.020-12.279, p=0.046). High tendency was seen in low LV ejection fraction and preoperative Ca antagonist admission. 2) Electrophysiological mapping study was performed during beating coronary artery surgery. However af was not developed and no data of af was obtained. During sinus rhythm abnormal potential was absent on atrium, SVC and pulmonary veins. New computer analyzing system of epicardial mapping for af was developed. Spectral analysis using a fast Fourier transforms was useful to check af cycle length. 3) To clarify the mechanism of spontaneous af, fast Fourier transform analysis of Holter EGG was used. Spectral analysis showed that spontaneous termination of af may depend on the disorganization of fibrillation waves and drug-induced termination may depend on the organization of af.