Research on the mechanism and management of atrial fibrillation after MIDCAB, OPCAB surgery

MIDCAB、OPCAB术后房颤发生机制及处理研究

• 批准号: 12470272
• 负责人: MISAKI Takurou
• 金额: $ 8.64万
• 依托单位: TOYAMA MEDICAL AND PHARMACEUTICAL UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-12470272/
• 关键词: MIDCAB; OPCAB; atrial fibrillation; epicarclial mapping; atril cyale length; spectral analysis; 心表面マツピング; 周波長解析; スブトラクション法; 冠動脈バイパス術; 体外循環; 電気生理学的手段; f波周波数解析; 心筋の異方向性

Atrial fibrillation (af) is frequent complication after coronary artery bypass surgery, but little was known after minimally invasive coronary artery bypass (MIDCAB) and off-pump coronary artery bypass (OPCAB).To determine the predictor of af after beating coronary artery bypass, multianalysis was performed using SPSS in MIDCAB (N=138) and OPCAB (N=129) patients. Postoperative af developed in 59 patients(22.1%).Multivariate predictors were preoperative combination of diabetes mellitus (CR4.844, 95%CI 2.356-9.958, p=0.000), preoperative renal failure (CR2.845, 95%CI 1.176-6.884, p=0.002) and bypass graft for right coronary artery (CR 3.540, 95%CI 1.020-12.279, p=0.046). High tendency was seen in low LV ejection fraction and preoperative Ca antagonist admission. 2) Electrophysiological mapping study was performed during beating coronary artery surgery. However af was not developed and no data of af was obtained. During sinus rhythm abnormal potential was absent on atrium, SVC and pulmonary veins. New computer analyzing system of epicardial mapping for af was developed. Spectral analysis using a fast Fourier transforms was useful to check af cycle length. 3) To clarify the mechanism of spontaneous af, fast Fourier transform analysis of Holter EGG was used. Spectral analysis showed that spontaneous termination of af may depend on the disorganization of fibrillation waves and drug-induced termination may depend on the organization of af.

冠状动脉搭桥手术后房颤（AF）是频繁的并发症，但在微创冠状动脉旁路（MidCAB）和非泵冠状动脉旁路（OPCAB）之后，几乎几乎不知所措。确定在冠状动脉旁路后，使用SPSS和N = N = N = N = N = N = N = N = N = N = N = N = N = 9，确定AF的预测因子。 Postoperative af developed in 59 patients(22.1%).Multivariate predictors were preoperative combination of diabetes mellitus (CR4.844, 95%CI 2.356-9.958, p=0.000), preoperative renal failure (CR2.845, 95%CI 1.176-6.884, p=0.002) and bypass graft for right coronary artery (CR 3.540，95％CI 1.020-12.279，p = 0.046）。在低LV射血分数和术前CA拮抗剂的入院中，观察到很高的趋势。 2）在跳动冠状动脉手术期间进行了电生理图研究研究。但是，没有开发AF，也没有获得AF的数据。在心房，SVC和肺静脉中，鼻窦节律异常的潜力不存在。开发了AF的心外膜映射系统的新计算机分析系统。使用快速傅立叶变换的光谱分析对于检查AF周期长度很有用。 3）为了阐明自发AF的机制，使用了快速的傅立叶变换分析，对霍特彩蛋进行了快速变换分析。光谱分析表明，自发终止可能取决于纤颤波的混乱和药物诱导的终止可能取决于AF的组织。

项目成果

渡邊剛: "Off-pump CABCの手術適応,手技と21世紀への課題"Jpn Thorac Cardiovasc Surg. 68(特別号). 153 (2000)

Tsuyoshi Watanabe：“21 世纪的非体外循环 CABC 手术适应症、技术和挑战”Jpn Thorac Cardiovasc Surg 68（特刊）。

Fujiki A: "Characteristics of fibrillation waves of right atrial free Wall in patients with conversion of atrial fibrillation to atrial flutter."Circulation. 102(18). 802 (2000)

Fujiki A：“心房颤动转化为心房扑动患者右心房游离壁颤动波的特征。”循环。

Fujiki A.: "Spectral characteristics of human atrial fibrillation waves of the right atrial free wall with respect to the duration of atrial fibrillation and effect of class I"Jpn Circ J. 65(12). 1047-1051 (2001)

Fujiki A.：“右心房游离壁的人类心房颤动波的频谱特征与心房颤动持续时间和 I 类效应的关系”Jpn Circ J. 65(12)。

Fujiki A.: "Relation of fibrillatory wave amplitude with hemostatic abnormality and left atrial appendage dysfunction in patients with chronic nonrheumatic atrial fibrillation"Jpn Circ J. 65(5). 375-380 (2001)

Fujiki A.：“慢性非风湿性心房颤动患者的颤动波振幅与止血异常和左心耳功能障碍的关系”Jpn Circ J. 65(5)。

土肥善郎: "正中切開off-pump CABG症例の検討"胸部外科. 54(4)(印刷中). (2001)

Yoshiro Doi：“中线切口非体外循环 CABG 病例的研究”《胸外科》54(4)（印刷中）。