https://scholars.lib.ntu.edu.tw/handle/123456789/558790
標題: | Malignant ventricular arrhythmias after off-pump coronary artery bypass | 作者: | JENG-WEI CHEN Lin, Cheng-Hsin |
公開日期: | 2015 | 出版社: | Elsevier | 卷: | 114 | 期: | 10 | 起(迄)頁: | 936-942 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background/Purpose: Sustained ventricular tachycardia and ventricular fibrillation (VT/VF) are rare complications after coronary surgery. Off-pump coronary artery bypass (OPCAB) was developed to decrease postoperative complications. No studies to date have specifically addressed VT/VF after OPCAB. We sought to assess the incidence, risk factors, and outcome of VT/VF after OPCAB. Methods: The study included a retrospective review of 1010 patients undergoing OPCAB between 2000 and 2012. Data were compared between the VT/VF patients and control patients who were the first cases of OPCAB in each month during the study period and did not have VT/VF. Results: Twenty-three patients (2.3%) developed VT/VF after OPCAB. The hospital mortality rate was 17.4%. In univariate analysis, the risk factors for VT/VF were old age, rapid heart rate, prolonged corrected QT interval, severe congestive heart failure, poor left ventricular ejection fraction, large left ventricular end-diastolic diameter, chronic kidney disease, preoperative dialysis, low blood hemoglobin level, preoperative intubation, recent myocardial infarction, high European System for Cardiac Operative Risk Evaluation, urgent/emergent operation, use of intra-aortic balloon pump, conversion to on-pump beating heart, postoperative dialysis, and no use of beta-blockers after operation. Multivariate analysis identified preoperative corrected QT interval > 426 milliseconds [odds ratio (OR) = 4.501; 95% confidence interval (CI) = 1.153-17.570] and estimated glomerular filtration rate < 30 mL/minute/1.73 m2 (OR = 4.876; 95% CI = 1.112-21.374) as independent risk factors. Conclusion: Postoperative VT/VF was rare after OPCAB but was associated with high mortality. Prolonged corrected QT interval and chronic kidney disease were independent risk factors. Recognition of these risk factors, proper prevention, and early intervention may improve survival. ? 2014. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84943359224&doi=10.1016%2fj.jfma.2014.02.005&partnerID=40&md5=be71830f6be063f54037c341e810f091 https://scholars.lib.ntu.edu.tw/handle/123456789/558790 |
ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2014.02.005 | SDG/關鍵字: | beta adrenergic receptor blocking agent; hemoglobin; adult; aged; Article; chronic kidney disease; clinical article; cohort analysis; confidence interval; congestive heart failure; controlled study; coronary artery bypass graft; dialysis; early intervention; EuroSCORE; female; glomerulus filtration rate; heart infarction; heart left ventricle ejection fraction; heart left ventricle enddiastolic volume; heart rate; heart ventricle arrhythmia; heart ventricle fibrillation; heart ventricle tachycardia; hemoglobin blood level; human; incidence; intraaortic balloon pump; intubation; male; middle aged; mortality; multivariate logistic regression analysis; observational study; off pump coronary surgery; postoperative complication; postoperative period; preoperative period; prognosis; prospective study; QT prolongation; QTc interval; receiver operating characteristic; retrospective study; risk factor; senescence; statistical analysis; univariate analysis; very elderly; adverse effects; heart ventricle fibrillation; heart ventricle tachycardia; hospital mortality; mortality; multivariate analysis; off pump coronary surgery; postoperative complication; risk assessment; statistical model; Taiwan; Adult; Aged; Aged, 80 and over; Coronary Artery Bypass, Off-Pump; Female; Hospital Mortality; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Postoperative Complications; Retrospective Studies; Risk Assessment; Risk Factors; ROC Curve; Tachycardia, Ventricular; Taiwan; Ventricular Fibrillation |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。