Detection and management of postoperative atrial fibrillation after coronary artery bypass grafting or non-cardiac surgery: a survey by the AF-SCREEN International Collaboration.

IF 3.2 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Giuseppe Boriani, Jacopo F Imberti, William F McIntyre, Davide A Mei, Jeff S Healey, Renate B Schnabel, Emma Svennberg, A John Camm, Ben Freedman
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引用次数: 0

Abstract

We developed a survey to describe current practice on the detection and management of new-onset postoperative atrial fibrillation (POAF) occurring after coronary artery bypass grafting (CABG) or non-cardiac surgery. We e-mailed an online anonymous questionnaire of 17 multiple choice or rank questions to an international network of healthcare professionals. Between June 2023 and June 2024, 158 participants from 25 countries completed the survey. For CABG patients, 62.7% of respondents reported use of telemetry to detect POAF on the ward until discharge, and 40% reported no dedicated methods for monitoring AF recurrences during follow-up. The largest number (46%) reported prescribing oral anticoagulants (OACs) at discharge if patients were at risk according to CHA2DS2-VASc/CHA2DS2-VA scores, and the most common duration of OAC therapy was 3 months to 1 year (43%). For non-cardiac surgery patients, POAF detection methods varied, with 29% using periodic 12-lead ECG and 27% using telemetry followed by periodic ECGs. For monitoring AF recurrence, 33% reported planned cardiology visits with ECG. Regarding OAC prescription during follow-up, 51% reported they prescribe OACs only for patients who are at risk of stroke, and 42% prescribe OACs for an interval of 3 months to 1 year. The most commonly reported barrier to OAC prescription was the lack of randomized controlled trial data. For both CABG and non-cardiac surgery, the reported methods for POAF detection and recurrences monitoring were heterogeneous and prescription patterns for OACs varied greatly. The most frequently reported concern about long-term anticoagulation was lack of randomized data, indicating the urgent need for sound studies that inform daily clinical practice.

冠状动脉旁路移植术或非心脏手术后房颤的检测和处理:AF-SCREEN国际合作的调查
我们进行了一项调查,以描述目前在冠状动脉旁路移植术(CABG)或非心脏手术后发生的新发术后心房颤动(POAF)的检测和管理。我们通过电子邮件向国际医疗保健专业人员网络发送了一份包含17个选择题或排名题的在线匿名问卷。在2023年6月至2024年6月期间,来自25个国家的158名参与者完成了这项调查。对于CABG患者,62.7%的受访者报告在出院前使用遥测技术检测房颤,40%的受访者报告在随访期间没有专门的方法监测房颤复发。根据CHA2DS2-VASc/CHA2DS2-VA评分,如果患者存在风险,出院时处方口服抗凝剂(OAC)的人数最多(46%),OAC治疗最常见的持续时间为3个月至1年(43%)。对于非心脏手术患者,POAF检测方法各不相同,29%使用12导联心电图,27%使用遥测和周期性心电图。为了监测房颤复发,33%的患者报告计划进行心脏科心电图检查。关于随访期间的OAC处方,51%的人报告他们只对有卒中风险的患者开OAC, 42%的人开OAC的间隔为3个月至1年。OAC处方最常见的障碍是缺乏随机对照试验数据。对于CABG和非心脏手术,报道的POAF检测和复发监测方法各不相同,OACs的处方模式差异很大。关于长期抗凝最常见的报道是缺乏随机数据,这表明迫切需要为日常临床实践提供可靠的研究。
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来源期刊
Internal and Emergency Medicine
Internal and Emergency Medicine 医学-医学:内科
CiteScore
7.20
自引率
4.30%
发文量
258
审稿时长
6-12 weeks
期刊介绍: Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.
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