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心房颤动导管消融术并发症分析

Complications of catheter ablation for atrial fibrillation

摘要:

目的 对心房颤动(房颤)导管消融术的并发症情况进行探讨.方法 2006年5月至2011年12月完成房颤导管消融术402例,其中阵发性房颤300例,持续及长期持续性房颤102例,男237例,女165例,年龄26~85(61.3±8.5)岁.阵发性房颤采用环肺静脉消融术式,部分病例结合神经节消融,持续及长期持续性房颤在环肺静脉消融基础上,采用递进式消融策略.对并发症情况进行回顾性分析.结果 402例房颤消融术中,共发生并发症23例,发生率为5.7%,其中心脏穿孔/压塞5例(1.2%)、膈神经损伤3例(0.7%)、脑动脉栓塞2例(0.5%)、肺动脉栓塞合并死亡1例(0.2%)、血胸1例(0.2%)、血管穿刺部位血肿7例(1.7%)、动-静脉瘘1例(0.2%)、假性动脉瘤3例(0.7%),无肺静脉狭窄及心房-食管瘘发生.结论 房颤导管消融术存在的并发症情况应引起足够重视.

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abstracts:

Objective To investigate the incidence of complications during catheter ablation for atrial fibrillation(AF).Methods A total of 402 AF patients[(61.3±8.5)years,237 males] who received catheter ablation in our hospital from May 2006 to December 2011 were enrolled,including 300 patients with paroxysmal AF(PAF) and 102 patients with persistent or long-standing persistent AF.Circumferential pulmonary vein ablation(CPVA) was performed in patients with paroxysmal AF,and some PAF patients also received catheter ablation of ganglionated plexi.Patients with persistent or long-standing persistent AF underwent CPVA and stepwise ablation approach.Complications occurred in 23 cases and were retrospectively analyzed.Results The incidence of complications during catheter ablation for AF was 5.7% (23 of 402 patients),including 5 (1.2%)cases of cardiac perforation or cardiac tamponade,3 (0.7 %) cases of phrenic nerve injury,2 (0.5 %) cases of cerebral embolism,1 (0.2%)case of death due to aggravated pulmonary embolism,1 (0.2%)case of haemothorax,7(1.7%) cases of hematoma at puncture site,1 (0.2%) case of arteriovenous fistula and 3 (0.7%) cases of pseudoaneurysm.No complications of pulmonary vein stenosis and esophageal fistula were found.Conclusions Complications of catheter ablation for AF should cause enough attention.

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