tailieunhanh - Báo cáo y học: "Pharmacologic prophylaxis for atrial fibrillation following cardiac surgery: a systematic revie"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Pharmacologic prophylaxis for atrial fibrillation following cardiac surgery: a systematic review. | Koniari et al. Journal of Cardiothoracic Surgery 2010 5 121 http content 5 1 121 REVIEW JOTS JOURNAL OF CARDIOTHORACIC SURGERY Open Access Pharmacologic prophylaxis for atrial fibrillation following cardiac surgery a systematic review Ioanna Koniari Efstratios Apostolakis Christina Rogkakou Nikolaos G Baikoussis Dimitrios Dougenis Abstract Atrial Fibrillation AF is the most common arrhythmia occurring after cardiac surgery. Its incidence varies depending on type of surgery. Postoperative AF may cause hemodynamic deterioration predispose to stroke and increase mortality. Effective treatment for prophylaxis of postoperative AF is vital as reduces hospitalization and overall morbidity. Beta - blockers have been proved to prevent effectively atrial fibrillation following cardiac surgery and should be routinely used if there are no contraindications. Sotalol may be more effective than standard b-blockers for the prevention of AF without causing an excess of side effects. Amiodarone is useful when beta-blocker therapy is not possible or as additional prophylaxis in high risk patients. Other agents such as magnesium calcium channels blocker or non-antiarrhythmic drugs as glycose-insulin - potassium non-steroidal anti-inflammatory drugs corticosteroids N-acetylcysteine and statins have been studied as alternative treatment for postoperative AF prophylaxis. Introduction Atrial Fibrillation AF is the most common arrhythmia occurring after cardiac surgery and its peak incidence is between second or third postoperative day. Postoperative AF ranges depending on surgery type. Especially AF occurs in nearly 30 of patients undergoing coronary bypass grafting CABG and in 40 and 50 of patients after valve surgery alone or combined valve and CABG surgery respectively 1 2 . Pathophysiologic parameters such as the abnormal electrophysiological state of the atria the unequal shortening of the atrial myocytes refractory period as well as variable conduction