冠状动脉搭桥术后早期新发房颤的相关因素分析

A retrospective study of atrial fibrillation after coronary artery bypass graft surgery

目的 探讨冠状动脉搭桥手术后心房颤动的发生率及相关因素。方法 对70 例冠状动脉搭桥术的病人进行回顾,分析年龄、β阻滞剂的使用、电解质、右冠状动脉、体外循环冠状动脉搭桥术与非体外循环冠状动脉搭桥术等因素与心房颤动的关系。结果 70例冠状动脉搭桥手术新发心房颤动15例,发生率21%,其中体外循环冠状动脉搭桥术后发生12例(30%),非体外循环冠状动脉搭桥术后发生3例(10.7%),15例心房颤动病人有4例未用β阻滞剂,体外循环冠状动脉搭桥手术组病人平均年龄62.3岁,非体外循环冠状动脉搭桥手术组病人平均年龄63 岁。结论 冠状动脉搭桥手术后新发心房颤动原因较多,可能与高龄,心肌缺血,右冠状动脉病变,围手术期停用β阻滞剂有关。

Objective To evaluate the incidence and clinical predictors of new-onset atrial fibrillation after coronary artery bypass graft surgery.Methods Seventy patients undergoing coronary artery bypass graft surgery were reviewed.Results Fifteen new-onset atrial fibrillation(21%) occurred in 70 patients after coronary artery bypass graft surgery. On-pump CABG group had 12 patients with new-onset atrial fibrillation(21%), off-pump CABG group had 3 patients with new-onset atrial fibrillation(10.7%), The mean age for patients with atrial fibrillation on-pump CABG group was 62.3 years compared with 63 years in off-pump CABG group. Four patients with withdrawal β blocker(26%) in fifteen new-onset atrial fibrillation patients.Conclusions The most causes of atrial fibrillation after coronary artery bypass graft surgery have advanced age , lesions in proximal segment of right coronary artery, βblocker withdrawal, lower blood magnesium level.