Gunda Sampath, Reddy Madhu, Nath Jayant, Nagaraj Hosakote, Atoui Moustapha, Rasekh Abdi, Ellis Christopher R, Badhwar Nitish, Lee Randall J, DI Biase Luigi, Mansour Moussa, Ruskin Jeremy N, Natale Andrea, Earnest Matthew, Lakkireddy Dhanunjaya R
University of Kansas Medical Center, Kansas City, Kansas, USA.
Nebraska Heart Institute, Lincoln, Nebraska, USA.
J Cardiovasc Electrophysiol. 2016 Jan;27(1):60-4. doi: 10.1111/jce.12869. Epub 2015 Dec 11.
Left atrial appendage (LAA) can be effectively and safely excluded using a novel percutaneous LARIAT ligation system. However, due to pericardial catheter manipulation and LAA ligation and subsequent necrosis, postprocedural course is complicated by pericarditis. We intended to evaluate the preprocedural use of colchicine on the incidence of postprocedural pericardial complications.
In this multicenter observational study, we included all consecutive patients who underwent LARIAT procedure at the participating centers. Many patients received periprocedural colchicine at the discretion of the physician. We compared the postprocedural outcomes of patients who received prophylactic periprocedural colchicine (colchicine group) with those who did not receive colchicine (standard group). A total of 344 consecutive patients, 243 in the "colchicine group" and 101 in the "standard group," were included. The mean age, median CHADS2VASc score, and HASBLED scores were 70 ± 11 years, 3 ± 1.7, and 3 ± 1.1, respectively. There were no significant differences in major baseline characteristics between the two groups. Severe pericarditis was significantly lower in the "colchicine group" compared to the "standard group" (10 [4%] vs. 16 [16%] P<0.0001). The colchicine group, compared to the standard group, had lesser pericardial drain output (186 ± 84 mL vs. 351 ± 83, P<0.001), shorter pericardial drain duration (16 ± 4 vs. 23 ± 19 hours, P<0.04), and similar incidence of delayed pericardial effusion (4 [1.6%] to 3 [3%], P = 0.42) when compared to the standard group.
Use of colchicine periprocedurally was associated with significant reduction in postprocedural pericarditis and associated complications.
使用新型经皮LARIAT结扎系统可有效且安全地排除左心耳（LAA）。然而，由于心包导管操作、LAA结扎及随后的坏死，术后病程会因心包炎而变得复杂。我们旨在评估术前使用秋水仙碱对术后心包并发症发生率的影响。
在这项多中心观察性研究中，我们纳入了在参与中心接受LARIAT手术的所有连续患者。许多患者根据医生的判断在围手术期接受了秋水仙碱治疗。我们将接受围手术期预防性秋水仙碱治疗的患者（秋水仙碱组）与未接受秋水仙碱治疗的患者（标准组）的术后结果进行了比较。总共纳入了344例连续患者，其中“秋水仙碱组”243例，“标准组”101例。平均年龄、CHADS2VASc评分中位数和HASBLED评分分别为70±11岁、3±1.7和3±1.1。两组主要基线特征无显著差异。与“标准组”相比，“秋水仙碱组”严重心包炎的发生率显著更低（10例[4%]对16例[16%]，P<0.0001）。与标准组相比，秋水仙碱组心包引流量更少（186±84 mL对351±83 mL，P<0.001），心包引流持续时间更短（16±4小时对23±19小时，P<0.04），与标准组相比延迟心包积液的发生率相似（4例[1.6%]对3例[3%]，P = 0.42）。
围手术期使用秋水仙碱与术后心包炎及相关并发症的显著减少有关。
