Atrial ectopic activity and atrial fibrillation/flutter after coronary artery bypass surgery. A case-base study controlling for confounding from age, β-blocker treatment, and time distance from
- 作者：Frost ; Lars ; Mø ; lgaard ; Henning ; Christiansen ; Evald Hø ; j ; Jacobsen ; Carl-Johan ; et. al.
- 关键词：Atrial fibrillation ; Atrial electrophysiology ; Atrial flutter ; Coronary artery bypass surgery ; Heart rate variability ; Heart surgery ; Holter monitoring ; Supraventricular tachyarrhythmia
- 刊名：International Journal of Cardiology
- 出版年：1995
- 期刊代码：128_01675273
- 类别：med
- 出版时间：June 30, 1995
- 卷：50
- 期：2
- 页码：153-162
- 文件大小：624 K
摘要
To evaluate the impact of ectopic atrial activity and cardiac autonomic function for development of atrial fibrillation or flutter we studied 128 consecutive patients undergoing elective coronary artery bypass grafting. The patients were Holter monitored during a 96-h postoperative period. Autonomic balance was estimated by heart rate variability measurement. Thirty-eight (30%) patients developed sustained atrial fibrillation or flutter. Holter recordings were analyzed in a case-base design matching for age, β-blocker treatment, and time elapsed after the operation. The number of supraventricular ectopic beats/h was increased (P < 0.01) in the case group during each of the last 7 h before onset of atrial fibrillation or flutter. Episodes of supraventricular tachycardia 62%vs. 26%; cases vs. controls (P = 0.007), episodes of non-sustained atrial fibrillation 29%vs. 0%(P = 0.0009), and episodes of non-sustained atrial flutter 15%vs. 0%(P = 0.05) were significant predictors of atrial fibrillation or flutter. Mean heart rate/h was increased in each of the 24 h preceding the arrhythmia. However, indexes of autonomic heart function did not differ significantly between groups. Patients developing atrial fibrillation or flutter after coronary artery bypass surgery present ‘warning’ atrial arrhythmias: numerous supraventricular ectopic beats, paroxysmal supraventricular tachycardia, and episodes of non-sustained atrial fibrillation and flutter.