Clinical practices for defining, detecting, and diagnosing postoperative atrial fibrillation after coronary revascularization surgery – A scoping review

IF 2.6 3区 医学 Q2 CRITICAL CARE MEDICINE Australian Critical Care Pub Date : 2025-01-01 DOI:10.1016/j.aucc.2024.06.006
Megan Higgs RN, MN , Julee McDonagh RN, PhD , Jenny Sim RN, PhD
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Abstract

Objectives

This scoping review was undertaken to understand the degree of variation in clinical practices associated with postoperative atrial fibrillation (POAF), following coronary revascularization surgery by collating and synthesising key concepts from current published literature.

Review methods and data sources

This scoping review was conducted following the framework outlined by Askey and O'Malley. Reporting of this scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.
Initial searches were completed in September 2020 and updated in January 2023. Comprehensive searches to identify relevant published literature were carried out within CINAHL, MEDLINE, and ProQuest databases. All searches were limited to full-text papers published in English with human adult participants. Deductive content analysis using NVivo software was performed to synthesise the data.

Results

A total of 692 studies were identified during the database searches. After the deletion of duplicates and the application of the inclusion and exclusion criteria, 73 studies were included in the scoping review. The included studies were published between 2001 and 2022 and included a total of 24,833 participants. Forty-six studies included a definition of POAF, with four of these citing a peak-body definition. A total of 24 included studies reported on electrocardiogram diagnostic criteria for POAF, with 13/24 [54%] describing these characteristics within their definition. The time-based diagnostic criteria ranged from a minimum duration of greater than 30 seconds to greater than 1 hour. The most frequently reported minimum-time thresholds were ≥30 seconds, reported in 12 of 51 (24%) studies and ≥5 min, reported in 13 of 51 (25%) studies.

Conclusions

There is a lack of consistency in clinical practice for defining, detecting, and diagnosing POAF, following coronary revascularization surgery. Consensus and standardisation of clinical practices are urgently needed.
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冠状动脉血运重建手术后定义、检测和诊断术后心房颤动的临床实践 - 范围综述。
目的:通过整理和归纳目前已发表文献中的关键概念,本范围综述旨在了解冠状动脉血运重建手术后与术后心房颤动(POAF)相关的临床实践的差异程度:本范围界定综述按照 Askey 和 O'Malley 概述的框架进行。本范围界定综述的报告遵循《系统综述和元分析首选报告项目扩展范围界定综述清单》。初步检索于 2020 年 9 月完成,并于 2023 年 1 月更新。在 CINAHL、MEDLINE 和 ProQuest 数据库中进行了全面检索,以确定已发表的相关文献。所有检索仅限于以英语发表的、有成人参与的全文论文。使用 NVivo 软件进行了演绎式内容分析,以综合数据:结果:在数据库搜索过程中,共发现了 692 项研究。在删除重复研究并应用纳入和排除标准后,73 项研究被纳入范围界定审查。纳入的研究发表于 2001 年至 2022 年之间,共有 24,833 名参与者。46 项研究包含 POAF 的定义,其中 4 项引用了峰值体定义。共有 24 项纳入的研究报告了 POAF 的心电图诊断标准,其中 13/24 [54%] 在其定义中描述了这些特征。基于时间的诊断标准从最短持续时间超过 30 秒到超过 1 小时不等。51 项研究中有 12 项(24%)报告了最低时间阈值≥30 秒,51 项研究中有 13 项(25%)报告了最低时间阈值≥5 分钟:结论:冠状动脉血运重建手术后,临床实践中对 POAF 的定义、检测和诊断缺乏一致性。临床实践迫切需要达成共识和标准化。
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来源期刊
Australian Critical Care
Australian Critical Care NURSING-NURSING
CiteScore
4.90
自引率
9.10%
发文量
148
审稿时长
>12 weeks
期刊介绍: Australian Critical Care is the official journal of the Australian College of Critical Care Nurses (ACCCN). It is a bi-monthly peer-reviewed journal, providing clinically relevant research, reviews and articles of interest to the critical care community. Australian Critical Care publishes peer-reviewed scholarly papers that report research findings, research-based reviews, discussion papers and commentaries which are of interest to an international readership of critical care practitioners, educators, administrators and researchers. Interprofessional articles are welcomed.
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