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室性早搏消融的安全性和有效性:来自德国消融登记处的数据。

Safety and efficacy in ablation of premature ventricular contraction: data from the German ablation registry.

作者信息

Fichtner S, Senges J, Hochadel M, Tilz R, Willems S, Eckardt L, Deneke T, Lewalter T, Dorwarth U, Reithmann C, Brachmann J, Steinbeck G, Kääb S

机构信息

Klinikum der LMU München, Medizinische Klinik und Poliklinik I, Deutsches Zentrum für Herz-Kreislauferkrankungen (DZHK), partner site Munich Heart Alliance, Marchioninistr. 15, 81377, Munich, Germany.

Stiftung Institut für Herzinfarktforschung (IHF), Ludwigshafen, Germany.

出版信息

Clin Res Cardiol. 2017 Jan;106(1):49-57. doi: 10.1007/s00392-016-1022-9. Epub 2016 Aug 2.

Abstract

BACKGROUND

Patients with frequent premature ventricular contractions (PVCs) are often highly symptomatic with significantly reduced quality-of-life. We evaluated the outcome and success of PVC ablation in patients in the German Ablation Registry.

METHODS

The German Ablation Registry is a nationwide prospective multicenter database of patients who underwent an ablation procedure, initiated by the "Stiftung Institut für Herzinfarktforschung" (IHF), Ludwigshafen, Germany. Data were acquired from March 2007 to May 2011. Patients underwent PVC ablation in the enrolling ablation centers.

RESULTS

A total of 408 patients (age 53.5 ± 15 years, 55 % female) undergoing ablation for PVCs were included. 32 % of patients showed a co-existing structural heart disease. Acute ablation success of the procedure was 82 % in the overall patient group. In patients without structural heart disease, acute success was significantly higher compared with patients with structural heart disease (86 vs. 74 %, p = 0.002). All patients were discharged alive after a median of 3 days. No patient suffered an acute myocardial infarction, stroke, or major bleeding. After 12 months' follow-up, 99 % of patients were still alive showing a significant different mortality between patients with structural heart disease compared with those without (2.3 vs. 0 %, p = 0.012). In addition, 76 % of patients showed significantly improved symptoms after 12 months of follow-up.

CONCLUSION

Based on the data from this registry, ablation of PVCs is a safe and efficient procedure with an excellent outcome and improved symptoms after 12 months.

摘要

背景

频发室性早搏(PVC)患者通常症状明显,生活质量显著下降。我们在德国消融注册研究中评估了PVC消融的结果及成功率。

方法

德国消融注册研究是一个由德国路德维希港“心脏病研究基金会”(IHF)发起的全国性前瞻性多中心数据库,纳入接受消融手术的患者。数据采集时间为2007年3月至2011年5月。患者在参与研究的消融中心接受PVC消融。

结果

共有408例接受PVC消融的患者(年龄53.5±15岁,55%为女性)被纳入研究。32%的患者合并结构性心脏病。总体患者组手术的急性消融成功率为82%。无结构性心脏病的患者急性成功率显著高于有结构性心脏病的患者(86%对74%,p = 0.002)。所有患者中位住院3天后均存活出院。无患者发生急性心肌梗死、中风或大出血。随访12个月后,99%的患者仍存活,有结构性心脏病的患者与无结构性心脏病的患者死亡率有显著差异(2.3%对0%,p = 0.012)。此外,随访12个月后,76%的患者症状明显改善。

结论

基于该注册研究的数据,PVC消融是一种安全有效的手术,12个月后效果良好且症状改善。

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