Department of Cardiology, Royal Jubilee Hospital, Victoria, British Columbia, Canada.
Postgrad Med J. 2010 Jul;86(1017):395-8. doi: 10.1136/pgmj.2009.092510.
Percutaneous catheter ablation for atrial fibrillation (AF) is a procedure performed typically in an inpatient setting. The feasibility and safety of catheter ablation in patients with paroxysmal and persistent AF were evaluated on an outpatient basis.
230 AF ablation procedures were performed in 206 patients (74% male; mean age 56+/-9 years). Patients were admitted to the hospital outpatient facility in the morning for the AF ablation procedure on the same day. The ablation strategy consisted of wide area circumferential lines around both ipsilateral pulmonary veins. After monitoring in the outpatient service, patients were discharged on the same day, if they were clinically stable.
Mean procedure time was 201+/-31 min. Major complications occurred in seven patients (3%). One patient (0.4%) suffered a minor stroke and six patients had pericardial tamponade requiring percutaneous drainage. Patients could be discharged on the same day following 205 (89%) procedures. Among the 148 patients whose clinical outcome was assessed at 6 months, 127 (86%) had a reduction of the total symptomatic AF episodes, compared to pre-ablation, with a complete lack of symptoms in 101 patients (68%).
Catheter ablation of AF on the day of admission is feasible and safe with a low risk of complications. The vast majority of the patients can be discharged on the same day.
经皮导管消融术治疗心房颤动(AF)通常在住院环境下进行。本研究旨在评估在门诊基础上对阵发性和持续性 AF 患者进行导管消融术的可行性和安全性。
共对 206 例患者(74%为男性,平均年龄 56+/-9 岁)的 230 次 AF 消融手术进行了评估。患者于手术当天上午在医院门诊办理入院,当日即可进行 AF 消融手术。消融策略包括双侧同侧肺静脉周围的广泛环形线。在门诊监测后,如果患者临床稳定,即可当日出院。
平均手术时间为 201+/-31 分钟。7 例患者(3%)发生主要并发症。1 例(0.4%)患者发生轻微中风,6 例患者发生心包填塞,需行经皮引流。205 例(89%)患者可在当日出院。在 148 例进行了 6 个月临床随访的患者中,与消融前相比,127 例(86%)患者的总症状性 AF 发作次数减少,101 例(68%)患者完全无症状。
入院当日行 AF 导管消融术是可行且安全的,并发症风险低。绝大多数患者可当日出院。