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首页> 外文期刊>Current pharmaceutical design >Inflammation, Atrial Fibrillation and Cardiac Surgery: Current Medical and Invasive Approaches for the Treatment of Atrial Fibrillation
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Inflammation, Atrial Fibrillation and Cardiac Surgery: Current Medical and Invasive Approaches for the Treatment of Atrial Fibrillation

机译：炎症，心房颤动和心脏手术：目前治疗心房颤动的医疗和侵袭性方法

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Atrial fibrillation (AF) is a cardiac dysrhythmia commonly seen in clinical practice especially after cardiac surgery. It is associated with increased morbidity and mortality for the patients. The pathogenesis of AF is not exactly understood yet, but there is growing data about the relationship between AF and inflammation. Cardiac surgery itself is a big source for inflammation. It causes major surgical trauma, ischemia/reperfusion injury, hypothermia, low arterial pressure, and the equipment of cardiopulmonary bypass makes a large foreign surface thus it activates inflammatory response. There is a large number of data about the treatment options of AF and there are also strategies, which are related to reduction of inflammatory activation during cardiopulmonary bypass. In order to review the relationship between cardiac surgery, inflammation, AF and treatment strategies in patients with AF, we conducted a search through Pubmed for articles in English using the keywords: "atrial fibrillation, cardiac surgery, inflammation, medical therapy, surgical therapy, ablation therapy" from January 2012 to present. We also searched separately for each alternative treatment modality on Pubmed. To identify further articles, we also looked into related citations in review articles and commentaries. We searched thoroughly the guidelines published by the European Society of Cardiology (2016), and the American Heart Association/American College of Cardiology/Heart Rhythm Surgery (2014). Many studies concluded that inflammation contributes in the occurrence of AF. Inflammatory markers, such as CRP, interleukins and complements have high sensitivity and specificity for prediction of AF whether the patient having cardiac surgery or not. Beta-blockers, diltiazem and amiodarone are the most commonly used drugs for rate control in AF following surgery. Although there are some new therapeutic approaches to reduce postoperative inflammatory activation, such as the use of vitamins, fatty acids, statins, or technical improvements to cardiopulmonary bypass unit like miniaturized bypass circuits, heparin coating of the circuits, leukocyte filters, or various surgical approaches like off-pump coronary bypass surgery, we still need more effective strategies to reduce both postoperative inflammation and postoperative AF risk after cardiac surgery. Today we use more advanced invasive and surgical treatment strategies for AF although we need far more advanced technics to reduce perioperative inflammatory activation, which actually causes AF.
机译：心房颤动（AF）是一种常见于临床实践中的心肌炎，特别是在心脏手术后常见。它与患者的发病率和死亡率增加有关。 AF的发病机制尚未完全理解，但是关于AF和炎症之间的关系存在日益增长的数据。心脏手术本身是炎症的重要来源。它会导致主要手术创伤，缺血/再灌注损伤，低温，低动脉压力，并且心肺旁路设备使得大型异物，因此它激活炎症反应。关于AF的治疗方案有大量数据，还有策略，与心肺旁路期间炎症激活的减少有关。为了回顾心脏手术，炎症，AF和AF患者治疗策略的关系，我们使用关键词通过英语文章进行了搜索：“心房颤动，心脏手术，炎症，医疗治疗，手术治疗，消融治疗“从2012年1月到现在。我们还在PubMed上单独搜索了每种替代治疗方式。要确定进一步的文章，我们还调查了审查文章和评论中的相关引用。我们彻底搜索了欧洲心脏病学（2016年）和美国心脏协会/美国心脏病学院/心脏节奏外科（2014年）的指导方针。许多研究得出结论，炎症有助于AF的发生。炎症标志物，如CRP，白细胞介介金和补充具有高灵敏度和特异性，用于预测AG是否具有心脏手术的患者。 β-封锁剂，Diltiazem和胺碘酮是AF手术中最常用的药物用于术后速率控制。虽然有一些新的治疗方法可以减少术后炎症激活，例如使用维生素，脂肪酸，他汀类药物或技术改进，如小型化旁路电路，电路，白细胞过滤器或各种手术方法的肝素涂层像泵浦冠状动脉旁路手术一样，我们仍需要更有效的策略来减少心脏手术后术后炎症和术后AF的风险。如今，我们使用更先进的侵入性和外科治疗策略，虽然我们需要更多先进的技术来减少围手术期炎症激活，但实际上会导致AF。

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