同时进行 Maze-V 术和冠状动脉旁路移植术后心房颤动复发的预测因素

A. Revishvili, V. Popov, E. Malyshenko, M. M. Anishchenko, N. V. Popova, M. W. Kadyrova, V. V. Aminov, M. Svetkin
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引用次数: 0

摘要

目的确定同时进行 Maze V 手术和冠状动脉旁路移植术后心房颤动(房颤)复发的预测因素。方法:回顾性分析 102 例冠心病合并房颤患者的病历。所有患者均接受了冠状动脉搭桥术和 Maze V 联合术。患者被分为两组:51 例阵发性房颤患者(I 组)和 51 例非阵发性房颤患者(II 组)。在 I 组中,发现 6 例房颤复发(IA 亚组),而 45 例患者(IB 亚组)在整个随访期间保持窦性心律。因此,在第二组中,9 名患者(IIA 亚组)发现房颤复发,42 名患者(IIB 亚组)发现窦性心律。随访期为 36 个月。研究将临床和超声心动图参数作为房颤复发的预测因素。阵发性房颤患者在住院阶段房颤复发是一个重要的预测因素(奇数比(OR)10.25;95% 置信区间(CI)1.53-68.20;р=0.032)。房颤病史持续时间是非阵发性房颤患者的主要预测因素(OR 8,8;95% CI 1,01-76,1;р=0.04)。ROC分析显示,左心房(LA)尺寸大于48.5毫米、左心房容积指数大于44.4毫升/平方米(阵发性房颤患者)和左心室舒张末期容积大于150毫升(非阵发性房颤患者)对房颤复发有明显影响。阵发性房颤患者在住院阶段房颤复发、LA尺寸、LA容积指数是冠状动脉旁路移植术+Maze V术后房颤复发的重要预测因素。长期房颤病史和左心室舒张末期容积对非阵发性房颤患者具有预测作用。
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Predictors of atrial fibrillation recurrence after simultaneous Maze-V procedure and coronary artery bypass grafting
Aim. To identify the predictors of atrial fibrillation (AF) recurrence after simultaneous Maze V procedure in combination with coronary artery bypass grafting.Methods. Medical records of 102 patients with coronary artery disease and concomitant AF were retrospectively reviewed. All patients underwent coronary artery bypass grafting and the combined Maze V procedure. The patients were divided into 2 groups: 51 patients with paroxysmal AF (group I), and 51 patients with non-paroxysmal AF (group II). In group I, 6 cases of AF recurrence were detected (subgroup IA), while 45 patients (subgroup IB) maintained sinus rhythm for the entire follow-up period. Accordingly, in group II, the return of AF was noted in 9 patients (subgroup IIA), sinus rhythm - in 42 patients (subgroup IIB). The follow-up period was 36 months. Clinical and echocardiographic parameters were studied as predictors of AF recurrence.Results. A significant predictor in patients with paroxysmal AF was a recurrence of AF at the hospital stage (odd ratio (OR) 10,25; 95% confidence interval (CI) 1,53-68,20; р=0.032). The duration of the AF history was the main predictor in patients with non-paroxysmal AF (OR 8,8; 95% CI 1,01-76,1; р=0.04). ROC analysis revealed a significant effect on the AF recurrence of left atrium (LA) dimension >48.5 mm, LA volume index >44.4 ml/m2 for patients with paroxysmal AF, and left ventriclular end-diastolic volume > 150 ml for patients with non-paroxysmal AFConclusion. A recurrence of AF at the hospital stage, LA dimension, LA volume index were significant predictors of AF recurrence after coronary artery bypass grafting + Maze V procedure in patients with paroxysmal AF. А long AF history and left ventriclular end-diastolic volume played the role of predictors for patients with non-paroxysmal AF.
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