关于心房颤动导管消融术操作安全性的全国多中心最新登记报告。
Updated national multicenter registry on procedural safety of catheter ablation for atrial fibrillation.
作者信息
Bertaglia Emanuele, Stabile Giuseppe, Pappone Alessia, Themistoclakis Sakis, Tondo Claudio, De Sanctis Valerio, Soldati Ezio, Tritto Massimo, Solimene Francesco, Grimaldi Massimo, Zoppo Franco, Pandozi Claudio, Augello Giuseppe, Calò Leonardo, Pappone Carlo
机构信息
Cardiology Clinic, Department of Cardiological, Thoracic and Vascular Sciences, University of Padua Medical School.
出版信息
J Cardiovasc Electrophysiol. 2013 Oct;24(10):1069-74. doi: 10.1111/jce.12194. Epub 2013 Jun 25.
INTRODUCTION
Despite catheter ablation (CA) becoming an accepted treatment option for symptomatic, drug-resistant atrial fibrillation (AF), safety of this procedure continues to be cause for concern. Aim of the present multicenter registry was to assess the incidence of early CA complications and detect their predictors in a contemporary, unselected AF population
METHODS AND RESULTS
From January 1, 2011 to December 31, 2011, data from 2,323 consecutive patients who underwent CA (median age 60 [52-67]; 72.3% male) for AF in 29 Italian centers were collected. All major complications occurring to the patient from admission to 30th postprocedural day were recorded. No procedure-related death was observed. Major complications occurred in 94 patients (4.0%): 50 patients (2.2%) suffered vascular access complications; 12 patients (0.5%) developed cardiac tamponade; 14 patients (0.6%) presented with pericarditis; 5 patients (0.2%) had transient ischemic attack; 4 patients had stroke; 3 patients (0.1%) had phrenic nerve paralysis; 3 patients (0.1%) had hemothorax. Other isolated but serious adverse events were documented in 3 patients (0.1%). Female gender (OR 2.643; 95% CI 1.686-4.143; P < 0.0001) and longer procedural duration (OR 2.195; 95% CI 1.388-3.473; P < 0.001) independently predicted a higher risk of complications.
CONCLUSION
Major complications occurred in 4.0% of the CA procedures for AF, with vascular access complications being the most frequent events.
引言
尽管导管消融术（CA）已成为有症状的、药物难治性心房颤动（AF）的一种可接受的治疗选择，但该手术的安全性仍是令人担忧的问题。本多中心注册研究的目的是评估当代未经过筛选的AF人群中CA早期并发症的发生率，并检测其预测因素。
方法与结果
收集了2011年1月1日至2011年12月31日期间，在意大利29个中心连续接受CA治疗AF的2323例患者（中位年龄60岁[52 - 67岁]；男性占72.3%）的数据。记录了患者从入院到术后第30天发生的所有主要并发症。未观察到与手术相关的死亡。94例患者（4.0%）发生了主要并发症：50例患者（2.2%）出现血管通路并发症；12例患者（0.5%）发生心脏压塞；14例患者（0.6%）出现心包炎；5例患者（0.2%）发生短暂性脑缺血发作；4例患者发生中风；3例患者（0.1%）出现膈神经麻痹；3例患者（0.1%）发生血胸。另有3例患者（0.1%）记录了其他孤立但严重的不良事件。女性（比值比2.643；95%置信区间1.686 - 4.143；P < 0.0001）和手术时间较长（比值比2.195；95%置信区间1.388 - 3.473；P < 0.001）独立预测并发症风险较高。
结论
AF的CA手术中有4.0%发生了主要并发症，血管通路并发症是最常见的事件。
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