Abstract：
Objectives. Atrial fibrillation is a common arrhythmia in patients with ischemic heart disease. This study aimed to determine the cumulative incidence of new-onset atrial fibrillation after percutaneous coronary intervention or coronary artery bypass grafting surgery during 30 days of follow-up. Design. This was a prospective multi-center cohort study on atrial fibrillation incidence following percutaneous coronary intervention or coronary artery bypass grafting for stable angina or non-ST-elevation acute coronary syndrome. Heart rhythm was monitored for 30 days postoperatively by in-hospital telemetry and handheld thumb ECG recordings after discharge were performed. The primary endpoint was the cumulative incidence of atrial fibrillation 30 days after the index procedure. Results. In-hospital atrial fibrillation occurred in 60/123 (49%) coronary artery bypass graft and 0/123 percutaneous coronary intervention patients (p < .001). The cumulative incidence of atrial fibrillation after 30 days was 56% (69/123) of patients undergoing coronary artery bypass grafting and 2% (3/123) of patients undergoing percutaneous coronary intervention (p < .001). CABG was a strong predictor for atrial fibrillation compared to PCI (OR 80.2, 95% CI 18.1-354.9, p < .001). Thromboembolic stroke occurred in-hospital in one coronary artery bypass graft patient unrelated to atrial fibrillation, and at 30 days in two additional patients, one in each group. There was no mortality. Conclusion. New-onset atrial fibrillation during 30 days of follow-up was rare after percutaneous coronary intervention but common after coronary artery bypass grafting. A prolonged uninterrupted heart rhythm monitoring strategy identified additional patients in both groups with new-onset atrial fibrillation after discharge.
摘要：
Objectives.心房颤动是缺血性心脏病患者常见的心律失常。这项研究旨在确定经皮冠状动脉介入治疗或冠状动脉旁路移植术后30天随访期间新发房颤的累积发生率。设计。这是一项前瞻性多中心队列研究，研究经皮冠状动脉介入治疗或冠状动脉旁路移植术治疗稳定型心绞痛或非ST段抬高型急性冠脉综合征后房颤的发生率。术后30天通过院内遥测监测心律，并在出院后进行手持拇指ECG记录。主要终点是指数程序后30天房颤的累积发生率。结果。60/123（49％）冠状动脉旁路移植术和0/123经皮冠状动脉介入治疗患者发生院内房颤（p<.001）。30天后房颤的累积发生率为56％（69/123）接受冠状动脉旁路移植术的患者和2％（3/123）接受经皮冠状动脉介入治疗的患者（p<0.001）。与PCI相比，CABG是房颤的强预测因子（OR80.2，95％CI18.1-354.9，p<.001）。血栓栓塞性卒中发生在一名与心房颤动无关的冠状动脉旁路移植术患者中，在另外两名患者的30天，每组一个。没有死亡。结论。在30天的随访期间，经皮冠状动脉介入治疗后很少发生新发房颤，但在冠状动脉旁路移植术后很常见。长期不间断的心律监测策略确定了两组中出院后新发房颤的其他患者。
