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Study on the Risk Factors for Atrial Fibrillation after Cardiac Surgery

Author: ShenYan
Tutor: WangHuiShan
School: Dalian Medical University
Course: Surgery
Keywords: cardiac surgery atrial fibrillation cardiopulmonary bypass risk factors
CLC: R654.2
Type: Master's thesis
Year: 2013
Downloads: 19
Quote: 0
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Abstract


Background: In recent years, postoperative atrial fibrillation was paid attention indomestic and overseas. Many researches indicated that age, hypertension, diabetes,myocardial infarction, the size of left atrium, left ventricular ejection fraction, operativetime, cardiopulmonary bypass and ventilator-assisted time and other factors are relatedto occurrence of atrial fibrillation after heart surgery. However, whethercardiopulmonary bypass was a risk factor for postoperative atrial fibrillation or not wasstill controversy.Objective: Atrial fibrillation is one of the most common complications after cardiacsurgery. Atrial fibrillation cannot make postoperative mortality increase, but themorbidity of other complications will increase including longer hospital stay, morecosts of hospitalization. How age and cardiopulmonary bypass impact on occurrence ofpostoperative atrial fibrillation are debatable. In this study, age and cardiopulmonarybypass were investigated for impact on atrial fibrillation after cardiac surgery in patientsin department of cardiovascular surgery, general hospital of Shenyang military region.Methods:1. Object: Group A: children with ventricular septal defect of congenital heart disease,(n=50). Group B: patients underwent mitral valve replacement surgery (n=50).Group C: patients underwent off-pump coronary artery bypass graft surgery (n=50).Group AF and non-AF: patients with postoperative atrial fibrillation or not from GroupB and C.2. The inclusion and exclusion criteria: Inclusion criteria: no atrial fibrillationpreoperatively, diabetes, hypertension, myocardial infarction and left atrial diameter<35cm preoperatively (This restriction does not apply to group A).Exclusion criteria: infection, immune system diseases, cancer, liver and kidneydysfunction.3. Data collection: the clinical data were obtained preoperatively and postoperatively, including age, gender, weight, mechanical ventilation time, duration of ICU stay andpostoperative hospital stay, the morbidity of postoperative atrial fibrillation andpostoperative infection.4. Statistical Methods: All data were used SPSS17.0statistical analysis software forstatistical analysis. Measurement data were expressed as±s, using the t test; countdata was used χ2test. P <0.05was significant difference.Results:1. Morbidity of atrial fibrillation in Group A was2%, which was significantly lowcompared with Group B and C (26%and24%)(P <0.05), Group B and C had nosignificant difference (P>0.05) in the morbidity of atrial fibrillation.2. Compared with Group non-AF, significantly older age (P <0.05), longer duration ofpostoperative ICU stay (P <0.05) and hospital stay (P <0.05) and higher morbidity ofpostoperative infection (P <0.05) were in Group AF.Conclusions:1. Low morbidity of atrial fibrillation postoperatively is in pediatric cardiac surgery.2. Cardiopulmonary bypass in adults after cardiac surgery was not risk factor for atrialfibrillation postoperatively.3. Advanced age is a risk factor on atrial fibrillation after cardiac surgery.

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CLC: > Medicine, health > Surgery > Of surgery > Cardiovascular and lymphatic system surgery > Heart
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