Curative efficacy and influencing factors of transesophageal atrial pacing to terminate atrial flutter after cardiac surgery

doi:10.11958/20222116

Abstract

Abstract:

Objective To investigate the clinical efficacy and influencing factors of transesophageal atrial pacing (TEAP) for atrial flutter after cardiac surgery. Methods A total of 298 patients with atrial flutter within 5 days after cardiac surgery in a single center were divided into the amiodarone group (control group, n=150) and the TEAP group (observation group, n=148) according to different treatment regimens. The differences of atrial diameter, operation related indicators, effective rate, adverse reactions and recurrence rate 6 months after operation were analyzed between the two groups. Logistic regression analysis was performed to analyze factors affecting the efficacy of TEAP terminating atrial flutter. Results There were no significant differences in atrial diameter and operation related parameters between the two groups. Compared with the control group, the effective rate was increased in the observation group (47.3% vs. 83.8%, P<0.05). There were no significant differences in adverse reactions, mortality during hospitalization and recurrence rate 6 months after operation between the two groups. Larger left atrial anteroposterior diameter (OR=1.156, 95%CI:1.066-1.255), continuous equal frequency stimulation (continuous stimulation) and termination mode (OR=6.019,95%CI:1.911-18.953) were independent risk factors for failure of atrial flutter in TEAP treatment. Conclusion TEAP is reliable to terminate atrial flutter after cardiac surgery. Continuous incremental stimulation (incremental stimulation) is recommended.

Key words: cardiac surgical procedures, atrial flutter, electrophysiologic techniques, cardiac, risk factors, program evaluation

CLC Number:

R654.2

Figures/Tables 6

References 19

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组别	n	性别（男/女）	年龄/岁	BMI/（kg/m²)	术前房颤史（无/有）
对照组	150	85/65	59.5±9.3	24.3±3.4	91/59
观察组	148	83/65	57.9±12.5	24.3±3.5	90/58
t或χ²		0.010	1.229	0.052	0.001

组别	n	性别（男/女）	年龄/岁	BMI/（kg/m²)	术前房颤史（无/有）
对照组	150	85/65	59.5±9.3	24.3±3.4	91/59
观察组	148	83/65	57.9±12.5	24.3±3.5	90/58
t或χ²		0.010	1.229	0.052	0.001

组别	n	左房前后径/mm	右房左右径/mm	房扑类型（典型/不典型）
对照组	150	42.6±6.7	37.0±5.4	80/70
观察组	148	43.0±7.8	37.9±7.5	92/56
t或χ²		0.443	1.179	2.379

组别	n	左房前后径/mm	右房左右径/mm	房扑类型（典型/不典型）
对照组	150	42.6±6.7	37.0±5.4	80/70
观察组	148	43.0±7.8	37.9±7.5	92/56
t或χ²		0.443	1.179	2.379

组别	n	手术类型（A/B/C^▲）	体外循环时长/min	主动脉阻断时长/min	术中出血量/mL
对照组	150	35/94/21	135.8±48.9	98.9±29.1	346.3±129.5
观察组	148	32/96/20	125.8±64.3	93.2±48.4	352.7±148.2
t或χ²		0.166	1.511	1.227	0.399