Analysis On Risk Factors Of Postoperative Atrial Fibrillation For Lung Cancer Patients

Objective: The hazard factors of postoperative auricular fibrillation for lung cancer was investigated.To provide direct data support for preventive treatment of patients at high risk of atrial fibrillation.Methods: The clinical data of 462 patients with stage IA-IIIA lung cancer who underwent radical resection of lung cancer from November 01,2015 to October 31,2017 were retrospectively analyzed.All patients returned to the ward after operation for continuous vital signs monitoring and perioperative symptomatic treatment.The incidence,time and duration of atrial fibrillation after lung cancer surgery were analyzed.The risk factors of AF after lung cancer surgery(such as age,type of lung cancer,pathological stage,preoperative neoadjuvant chemotherapy,operation mode,complications,number of lymph nodes in N2 group,cardiac color Doppler ultrasound detection index,smoking history,operation time,hemoglobin reduction before and after operation)were analyzed by single factor analysis,and the single factor analysis was meaningful.The parameters were compared by binary logistic regression analysis.Result: 1.The incidence,occurrence time,duration and outcome of atrial fibrillation after lung cancer surgery: In this study,the incidence of atrial fibrillation after lung cancer surgery was 12.3%(57/462);the first occurrence of atrial fibrillation varied from 6 hours to7 days after surgery;the incidence of atrial fibrillation within 24 hours after surgery was35.1%(20/57);the incidence of atrial fibrillation within 24-48 hours after surgery was40.4%(23/57);and the incidence of atrial fibrillation within 48-72 hours after surgery was17.The incidence of atrial fibrillation was 7.0%(4/57)72 hours after operation.After intravenous amiodarone and/or oral amiodarone treatment,most patients with AF can return to sinus rhythm.91.2%(52/57)of patients with atrial fibrillation after lung cancer surgery were transient,of which 50.9%(29/57)converted to sinus rhythm within 12 hoursafter treatment;29.8%(17/57)patients with atrial fibrillation lasted for 12-24 hours;10.5%(6/57)patients with atrial fibrillation lasted for 24-72 hours 2.The risk factors of AF after lung cancer surgery were analyzed by univariate analysis,and the significant factors were analyzed by multivariate analysis.Univariate analysis showed that age,location of tumors,pathological stage,pathological type,preoperative neoadjuvant chemotherapy,operative method,number of lymph nodes in N2 group,coronary heart disease,left atrial diameter,smoking history,hand,etc.The clinical parameters such as operation time,hemoglobin reduction before and after operation are the risk factors for atrial fibrillation after lung cancer operation.Multivariate regression analysis showed that the number of lymph nodes in the elderly and N2 groups was a risk factor for AF after lung cancer surgery.Conclusion: 1.The incidence of atrial fibrillation after lung cancer surgery is as high as12.3%,which is transient.After active and reasonable treatment,most patients can be converted to sinus rhythm.The empirical evidence provided by this study is helpful for clinicians to predict the incidence of atrial fibrillation after lung cancer surgery.2.This study selected many factors that may cause AF after lung cancer surgery.Multivariate regression analysis revealed that patients older than 65 years old and the number of N2 lymph nodes dissected during surgery were high risk factors for AF after surgery.