摘要
目的:探讨心房颤动(房颤)射频消融术后出现无症状性心包积液的危险因素。方法:选择首次接受房颤射频消融治疗的患者166例,术中根据房颤类型、肺静脉隔离情况,实施环肺静脉电隔离或肺静脉电隔离+左房消融径线的消融术式。术前及术后24 h常规行经胸心脏彩超检查,术后筛选出少量心包积液且无症状的患者,将心包积液与各危险因素进行统计分析。结果:房颤射频消融术后出现无症状性心包积液31例(心包积液组),无心包积液135例(非心包积液组)。心包积液组中阵发性房颤、非阵发性房颤分别为13例、18例,非心包积液组中分别为101例、34例(P=0.001)。心包积液组手术时间为(183.06±78.07)min,非心包积液组为(149.11±51.29)min,差异有统计学意义(P=0.005)。心包积液组术中电复律19例,非心包积液组37例(P=0.001)。消融术式:心包积液组中肺静脉电隔离术、肺静脉电隔离术+左房消融径线分别为6例、25例,非心包积液组中分别为61例、74例(P=0.003)。心包积液组的左房直径为(45.03±5.69)mm,非心包积液组为(41.41±6.59)mm,差异有统计学意义(P=0.005)。多因素Logistic回归分析显示,手术持续时间是房颤射频消融术后出现无症状性心包积液的独立危险因素[β=0.009,Exp(β)=1.009,Exp(β)的95%CI为:1.001～1.017,P=0.027]。结论:房颤射频消融手术持续时间长的患者中,术后易出现无症状性心包积液。
Objective：To investigate the risk factors of asymptomatic pericardial effusion（APE） after ablation in atrial fibrillation.Method：One hundred and sixty-six patients underwent radiofrequency ablation of pulmonary veins or pulmonary veins plus additional lines of left atrium.Conventional transthoracic echocardiography was performed in all patients on the day before and 24 h after ablation.Risk factors were analyzed.Result：APE was found in 31 patients（APE group） and non-pericardial effusion was found in the other 135 patients（NPE group）.There was 13 paroxysmal atrial fibrillation and 18 non-paroxysmal atrial fibrillation in APE group,while 101 and 34 in NPE group（P=0.001）.Duration of procedure was（183.06±78.07）min in the APE group and（149.11±51.29）min in the NPE group（P=0.005）.Cardioversion was done in 19 patients in APE group and 37 patients in NPE group（P=0.001）.Ablation of pulmonary veins was 6 and ablation of pulmonary veins plus additional left atrium was 25 in APE group,while 61 and 74 in NPE group（P=0.003）.Diameter of left atrium was（45.03±5.69） mm in APE group and（41.41±6.59） mm in NPE group（P=0.005）.Logistic regression analysis showed that the duration of procedure was the independent risk factor of APE after ablation [β=0.009,Exp（β）=1.009,95%CI of Exp（β）： 1.001-1.017,P=0.027].Conclusion：Duration of ablation procedure is the independent risk factor of APE after the ablation in atrial fibrillation.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2012年第11期824-827,共4页
Journal of Clinical Cardiology
关键词
心房颤动
射频消融
心包积液
危险因素
atrial fibrillation
radiofrequency ablation
asymptomatic pericardial effusion
risk factors
