1 research outputs found
ΠΡΠ΅Π΄ΠΈΠΊΡΠΎΡΠΈ Π·Π° ΠΏΠΎΡΠ°Π²Π° Π½Π° Π°ΡΡΠΈΡΠ°Π»Π½Π° ΡΠΈΠ±ΡΠΈΠ»Π°ΡΠΈΡΠ° ΠΏΠΎ Π°ΠΎΡΡΠΎ-ΠΊΠΎΡΠΎΠ½Π°ΡΠ½Π° Π±Π°ΡΠΏΠ°Ρ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΡΠ°
Atrial fibrillation (AF) is the most common type of arrhythmia following open heart surgery and it contributes to prolonged hospital stay, increased prevalence of thromboembolic complications and overall increased postoperative morbidity and mortality. The aim of this prospective observational follow-up study was to determine the incidence of postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass surgery, to identify predisposing risk factors for its occurrence in the immediate preoperative period and to assess its effect on the postoperative outcome in patients at the University Clinic for Cardiac Surgery in Skopje, North Macedonia. Material and methods: The study included patients at the University Clinic for Cardiac Surgery in Skopje, North Macedonia undergoing coronary artery bypass surgery. The experimental group included patients developing POAF, whereas the control group those who did not develop the primary outcome. All patients were followed up for a period of 30 days postoperatively. Results: POAF was registered in 38% of the patient population and more frequently in the elderly. Patients developing POAF had significantly higher left atrial volume index, as well as higher CHADS2-VASC2, HATCH and Euroscore I values. Average time to POAF occurrence was 48-72 hours postoperatively. There were death outcomes, thromboembolic events, longer hospital stay, need for antiarrhythmic and oral anticoagulant therapy in the POAF group. Conclusion: POAF significantly increases postoperative morbidity and mortality in patients undergoing coronary artery bypass surgery. Age, higher CHADS2-VASC2, HATCH and Euroscore I values and left atrial volume were found to be significant predictors of POAF after coronary artery bypass surgery.ΠΡΡΠΈΡΠ°Π»Π½Π°ΡΠ° ΡΠΈΠ±ΡΠΈΠ»Π°ΡΠΈΡΠ° (ΠΠ€) ΠΏΡΠ΅ΡΡΡΠ°Π²ΡΠ²Π° Π½Π°ΡΡΠ΅ΡΡΠΈΠΎΡ ΡΠΈΠΏ Π½Π° Π°ΡΠΈΡΠΌΠΈΡΠ° ΠΏΠΎ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ° Π½Π° ΠΎΡΠ²ΠΎΡΠ΅Π½ΠΎ ΡΡΡΠ΅ ΠΈ ΠΈΡΡΠ°ΡΠ° ΠΏΡΠΈΠ΄ΠΎΠ½Π΅ΡΡΠ²Π° Π·Π° ΠΏΡΠΎΠ»ΠΎΠ½Π³ΠΈΡΠ°Π½ Π±ΠΎΠ»Π½ΠΈΡΠΊΠΈ ΠΏΡΠ΅ΡΡΠΎΡ, Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½Π° ΠΈΠ½ΡΠΈΠ΄Π΅Π½ΡΠΈΡΠ° Π½Π° ΡΡΠΎΠΌΠ±Π΅ΠΌΠ±ΠΎΠ»ΠΈΡΠΊΠΈ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ ΠΈ ΠΎΠΏΡΡΠΎ Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½ ΠΏΠΎΡΡΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π΅Π½ ΠΌΠΎΡΠ±ΠΈΠ΄ΠΈΡΠ΅Ρ ΠΈ ΠΌΠΎΡΡΠ°Π»ΠΈΡΠ΅Ρ. Π¦Π΅Π»ΡΠ° Π½Π° ΠΎΠ²Π°Π° ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½Π°, ΠΎΠΏΡΠ΅ΡΠ²Π°ΡΠΈΡΠΊΠ° ΡΡΡΠ΄ΠΈΡΠ° Π½Π° ΡΠ»Π΅Π΄Π΅ΡΠ΅ Π±Π΅ΡΠ΅ Π΄Π° ΡΠ΅ ΡΡΠ²ΡΠ΄ΠΈ ΠΈΠ½ΡΠΈΠ΄Π΅Π½ΡΠΈΡΠ°ΡΠ° Π½Π° ΠΏΠΎΡΡΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½Π°ΡΠ° Π°ΡΡΠΈΡΠ°Π»Π½Π° ΡΠΈΠ±ΡΠΈΠ»Π°ΡΠΈΡΠ° (ΠΠΠΠ€) ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ ΠΊΠΎΠΈ ΠΏΠΎΠ΄Π»Π΅Π³Π½ΡΠ²Π°Π°Ρ Π½Π° Π°ΠΎΡΡΠΎ-ΠΊΠΎΡΠΎΠ½Π°ΡΠ½Π° Π±Π°ΡΠΏΠ°Ρ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΡΠ°, Π΄Π° ΡΠ΅ ΠΎΡΠΊΡΠΈΡΠ°Ρ ΠΏΡΠ΅Π΄ΠΈΡΠΏΠΎΠ½ΠΈΡΠ°ΡΠΊΠΈΡΠ΅ ΡΠΈΠ·ΠΈΠΊ-ΡΠ°ΠΊΡΠΎΡΠΈ Π·Π° ΠΏΠΎΡΠ°Π²Π° Π½Π° Π°ΡΡΠΈΡΠ°Π»Π½Π° ΡΠΈΠ±ΡΠΈΠ»Π°ΡΠΈΡΠ° Π²ΠΎ Π½Π΅ΠΏΠΎΡΡΠ΅Π΄Π½ΠΈΠΎΡ ΠΏΡΠ΅Π΄ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π΅Π½ ΠΏΠ΅ΡΠΈΠΎΠ΄, ΠΊΠ°ΠΊΠΎ ΠΈ Π΄Π° ΡΠ΅ Π΅Π²Π°Π»ΡΠΈΡΠ° Π½Π΅ΡΠ·ΠΈΠ½ΠΈΠΎΡ Π΅ΡΠ΅ΠΊΡ Π²ΡΠ· ΠΏΠΎΡΡΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΈΠΎΡ ΠΈΡΡ
ΠΎΠ΄ Π½Π° ΠΊΠ°ΡΠ΄ΠΈΠΎΡ
ΠΈΡΡΡΡΠΊΠΈΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Π½Π° ΠΠΠ£ Π£Π½ΠΈΠ²Π΅ΡΠ·ΠΈΡΠ΅ΡΡΠΊΠ° ΠΊΠ»ΠΈΠ½ΠΈΠΊΠ° Π·Π° ΠΊΠ°ΡΠ΄ΠΈΠΎΡ
ΠΈΡΡΡΠ³ΠΈΡΠ°Π²ΠΎΠ Π΅ΠΏΡΠ±Π»ΠΈΠΊΠ° Π‘Π΅Π²Π΅ΡΠ½Π° ΠΠ°ΠΊΠ΅Π΄ΠΎΠ½ΠΈΡΠ°. ΠΠ°ΡΠ΅ΡΠΈΡΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: ΠΠΎ ΠΎΠ²Π°Π° ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½Π° ΠΎΡΠ²ΠΎΡΠ΅Π½Π° ΡΡΡΠ΄ΠΈΡΠ° Π½Π° ΡΠ»Π΅Π΄Π΅ΡΠ΅ Π±Π΅Π° Π²ΠΊΠ»ΡΡΠ΅Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ
ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠ°Π½ΠΈ Π½Π° ΠΠΠ£ Π£Π½ΠΈΠ²Π΅ΡΠ·ΠΈΡΠ΅ΡΡΠΊΠ° ΠΊΠ»ΠΈΠ½ΠΈΠΊΠ° Π·Π° ΠΊΠ°ΡΠ΄ΠΈΠΎΡ
ΠΈΡΡΡΠ³ΠΈΡΠ°- Π‘ΠΊΠΎΠΏΡΠ΅ Π·Π° ΠΈΠ·Π²Π΅Π΄ΡΠ²Π°ΡΠ΅ Π½Π° Π°ΠΎΡΡΠΎ-ΠΊΠΎΡΠΎΠ½Π°ΡΠ½Π° Π±Π°ΡΠΏΠ°Ρ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΡΠ°. ΠΠΎ ΠΈΡΠΏΠΈΡΡΠ²Π°Π½Π°ΡΠ° Π³ΡΡΠΏΠ° Π±Π΅Π° Π²ΠΊΠ»ΡΡΠ΅Π½ΠΈ ΠΎΠ½ΠΈΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ, ΠΊΠΎΠΈ Π²ΠΎ ΠΏΠΎΡΡΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΈΠΎΡ ΠΏΠ΅ΡΠΈΠΎΠ΄ ΡΠ°Π·Π²ΠΈΡΠ° ΠΠΠΠ€, Π΄ΠΎΠ΄Π΅ΠΊΠ° Π²ΠΎ ΠΊΠΎΠ½ΡΡΠΎΠ»Π½Π°ΡΠ° Π³ΡΡΠΏΠ° Π±Π΅Π° Π²ΠΊΠ»ΡΡΠ΅Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ ΠΊΠΎΠΈ Π½Π΅ ΡΠ°Π·Π²ΠΈΡΠ° ΠΠΠΠ€. ΠΠΎΡΡΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ Π±Π΅Π° ΡΠ»Π΅Π΄Π΅Π½ΠΈ Π²ΠΎ ΠΏΠ΅ΡΠΈΠΎΠ΄ ΠΎΠ΄ 30 Π΄Π΅Π½Π° ΠΎΠ΄ ΠΊΠ°ΡΠ΄ΠΈΠΎΡ
ΠΈΡΡΡΡΠΊΠ°ΡΠ° ΠΈΠ½ΡΠ΅ΡΠ²Π΅Π½ΡΠΈΡΠ°. Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ: ΠΠΠΠ€ Π±Π΅ΡΠ΅ ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠ°Π½Π° ΠΊΠ°Ρ 38% ΠΎΠ΄ ΠΈΡΠΏΠΈΡΠ°Π½ΠΈΡΠΈΡΠ΅ ΠΈ ΡΠΎΠ° ΠΏΠΎΡΠ΅ΡΡΠΎ ΠΊΠ°Ρ ΠΏΠΎΠ²ΠΎΠ·ΡΠ°ΡΠ½Π°ΡΠ° Π³ΡΡΠΏΠ° ΠΈΡΠΏΠΈΡΠ°Π½ΠΈΡΠΈ. ΠΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ ΡΠΎ ΠΠΠΠ€ ΠΈΠΌΠ°Π° Π·Π½Π°ΡΠΈΡΠ΅Π»Π½ΠΎ ΠΏΠΎΠ²ΠΈΡΠΎΠΊΠ° Π²ΡΠ΅Π΄Π½ΠΎΡΡ Π½Π° ΠΈΠ½Π΄Π΅ΠΊΡΠΈΡΠ°Π½ΠΈΠΎΡ Π²ΠΎΠ»ΡΠΌΠ΅Π½ Π½Π° Π»Π΅Π²Π°ΡΠ° ΠΏΡΠ΅ΡΠΊΠΎΠΌΠΎΡΠ°, ΠΊΠ°ΠΊΠΎ ΠΈ Π·Π½Π°ΡΠΈΡΠ΅Π»Π½ΠΎ ΠΏΠΎΠ²ΠΈΡΠΎΠΊΠ° Π²ΡΠ΅Π΄Π½ΠΎΡΡ Π½Π° CHADS2-VASC2, HATCH ΠΈ Euroscore ΡΠΊΠΎΡΠΎΠ²ΠΈΡΠ΅,Π²ΠΎ ΠΎΠ΄Π½ΠΎΡ Π½Π° Π³ΡΡΠΏΠ°ΡΠ° Π±Π΅Π· ΠΠΠΠ€. ΠΡΠΎΡΠ΅ΡΠ½ΠΎΡΠΎ Π²ΡΠ΅ΠΌΠ΅ Π½Π° ΠΏΠΎΡΠ°Π²Π° Π½Π° ΠΠΠΠ€ Π±Π΅ΡΠ΅ 48-72 ΡΠ°ΡΠ° ΠΎΠ΄ Ρ
ΠΈΡΡΡΡΠΊΠ°ΡΠ° ΠΈΠ½ΡΠ΅ΡΠ²Π΅Π½ΡΠΈΡΠ°. ΠΠΎ Π³ΡΡΠΏΠ°ΡΠ° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ ΠΠΠΠ€ Π±Π΅Π· Π·Π°Π±Π΅Π»Π΅ΠΆΠ°Π½ΠΈ ΡΠΌΡΡΠ½ΠΈ ΡΠ»ΡΡΠ°ΠΈ, ΠΊΠ°ΠΊΠΎ ΠΈ ΡΡΠΎΠΌΠ±ΠΎΠ΅ΠΌΠ±ΠΎΠ»ΠΈΡΠΊΠΈ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ, ΠΎΠ΄ ΡΠΈΠΏΠΎΡ Π½Π° ΠΈΡΡ
Π΅ΠΌΠΈΡΠ΅Π½ ΠΌΠΎΠ·ΠΎΡΠ΅Π½ ΡΠ΄Π°Ρ ΠΈ ΠΎΠ²ΠΈΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΠΈΠΌΠ°Π° ΠΏΠΎΠ΄ΠΎΠ»Π³ Π±ΠΎΠ»Π½ΠΈΡΠΊΠΈ ΠΏΡΠ΅ΡΡΠΎΡ ΠΈ ΠΏΠΎΡΡΠ΅Π±Π° ΠΎΠ΄ Π°Π½ΡΠΈΠ°ΡΠΈΡΠΌΠΈΡΠ½Π° ΡΠ΅ΡΠ°ΠΏΠΈΡΠ° ΠΈ ΠΎΡΠ°Π»Π½Π° Π°Π½ΡΠΈΠΊΠΎΠ°Π³ΡΠ»Π°Π½ΡΠ½Π° ΡΠ΅ΡΠ°ΠΏΠΈΡΠ° (ΠΠΠ). ΠΠ°ΠΊΠ»ΡΡΠΎΠΊ: ΠΠΠΠ€ Π·Π½Π°ΡΠΈΡΠ΅Π»Π½ΠΎ Π³ΠΎ Π²Π»ΠΎΡΡΠ²Π° ΠΌΠΎΡΠ±ΠΈΠ΄ΠΈΡΠ΅ΡΠΎΡ ΠΈ ΠΌΠΎΡΡΠ°Π»ΠΈΡΠ΅ΡΠΎΡ ΠΊΠ°Ρ ΠΊΠ°ΡΠ΄ΠΈΠΎΡ
ΠΈΡΡΡΡΠΊΠΈΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ. ΠΠΎΠ·ΡΠ°ΡΡΠ°, Π²ΠΈΡΠΎΠΊΠ°ΡΠ° Π²ΡΠ΅Π΄Π½ΠΎΡΡ Π½Π° CHADS2-VASC2, HATCH ΠΈ Euroscore, ΠΊΠ°ΠΊΠΎ ΠΈ Π²ΠΎΠ»ΡΠΌΠ΅Π½ΠΎΡ Π½Π° Π»Π΅Π²Π°ΡΠ° ΠΏΡΠ΅ΡΠΊΠΎΠΌΠΎΡΠ° ΠΏΡΠ΅ΡΡΡΠ°Π²ΡΠ²Π°Π°Ρ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΈΠ²Π½ΠΈ ΡΠ°ΠΊΡΠΎΡΠΈ Π·Π° Π°ΡΡΠΈΡΠ°Π»Π½Π° ΡΠΈΠ±ΡΠΈΠ»Π°ΡΠΈΡΠ° Π²ΠΎ ΠΏΠΎΡΡΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΈΠΎΡ ΠΏΠ΅ΡΠΈΠΎΠ΄ ΠΏΠΎ Π°ΠΎΡΡΠΎ-ΠΊΠΎΡΠΎΠ½Π°ΡΠ½Π° Π±Π°ΡΠΏΠ°Ρ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΡΠ°