摘要
目的本研究旨在阐述使用重复经皮星状神经节阻滞术(R-SGB)治疗非缺血性心肌病室性心动过速(室速)电风暴的经验。方法本研究为前瞻性观察研究。连续纳入南京医科大学第一附属医院2021年6月1日至2022年1月31日药物干预无效的非缺血性心肌病合并室速电风暴患者。患者均在超声引导下接受左侧R-SGB,阻滞药物为5 ml 1%利多卡因,1次/d,连续阻滞7 d。记录患者治疗前后室性心律失常发作情况,随访出院后室性心律失常复发及临床转归情况。统计分析患者阻滞前后室速的负荷变化及长期预后情况。结果共纳入8例患者,年龄为(51.5±13.6)岁,均为男性,5例为扩张性心肌病,剩余2例为致心律失常性右心室心肌病和1例肥厚性心肌病,左心室射血分数为37.8%±6.6%。治疗后6例(75%)患者终止了电风暴,与治疗前[43.0(13.3,276.3)]相比,患者治疗开始后第1天[1.0(0.3,34.0),P<0.05]及治疗完成后第1天[0.5(0.0,19.3),P<0.05]的24 h内室速负荷均明显减少。治疗过程未发生操作相关重大并发症。干预后平均随访(4.8±1.1)个月,患者首次室速复发的中位时间为2个月。结论微创R-SGB是一种安全且有效的终止非缺血性心肌病室速电风暴的新方法,可作为稳定室速电风暴的重要过渡手段。
Objectives This study sought to describe our institutional experience of repeated percutaneous stellate ganglion blockade(R-SGB)as a treatment option for drug-refractory electrical storm in patients with nonischemic cardiomyopathy(NICM).Methods This prospective observational study included 8 consecutive NICM patients who had drug-refractory electrical storm and underwent R-SGB between June 1,2021 and January 31,2022.Lidocaine(5 ml,1%)was injected in the vicinity of the left stellate ganglion under the guidance of ultrasound,once per day for 7 days.Data including clinical characteristics,immediate and long-term outcomes,and procedure related complications were collected.Results The mean age was(51.5±13.6)years.All patients were male.5 patients were diagnosed as dilated cardiomyopathy,2 patients as arrhythmogenic right ventricular cardiomyopathy and 1 patient as hypertrophic cardiomyopathy.The left ventricular ejection fraction was 37.8%±6.6%.After the treatment of R-SGB,6(75%)patients were free of electrical storm.24 hours Holter monitoring showed significant reduction in ventricular tachycardia(VT)episodes from 43.0(13.3,276.3)to 1.0(0.3,34.0)on the first day following R-SGB(P<0.05)and 0.5(0.0,19.3)after whole R-SGB process(P<0.05).There were no procedure-related major complications.The mean follow-up was(4.8±1.1)months,and the median time of recurrent VT was 2 months.Conclusion Minimally invasive R-SGB is a safe and effective method to treat electrical storm in patients with NICM.
作者
崔畅
周晓凯
竺悦
沈尤美
陈林豆
居维竹
陈红武
顾凯
郦明芳
潘寅兵
陈明龙
Cui Chang;Zhou Xiaokai;Zhu Yue;Shen Youmei;Chen Lindou;Ju Weizhu;Chen Hongwu;Gu Kai;Li Mingfang;Pan YinBing;Chen Minglong(Department of Cardiology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Anaesthesiology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2023年第5期521-525,共5页
Chinese Journal of Cardiology
关键词
室性心动过速
电风暴
星状神经节
神经阻滞
交感神经
Ventricular tachycardia
Electrical storm
Stellate ganglion
Nerve blocks
Sympathetic nerve
