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秘鲁卫生部系统的首例导管消融术:初步经验报告。

First catheter ablations in the Ministry of Health system of Peru: Report of the initial experience.

作者信息

Montañez-Valverde Raúl A, More Luis Alberto, Mendoza-Novoa Pablo

机构信息

Beth Israel Deaconess Medical Center/Harvard Medical School, Cardiovascular Division, Boston, MA, USA.

Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru.

出版信息

Int J Cardiol Heart Vasc. 2019 Jul 27;24:100402. doi: 10.1016/j.ijcha.2019.100402. eCollection 2019 Sep.

Abstract

BACKGROUND

In 2015, the Ministry of Health (MINSA) of Peru inaugurated the first national center for electrophysiology studies in a public tertiary referral hospital with the purpose to provide healthcare access to the most underserved population. This study aims to describe the rate of success and complications of catheter ablation in this center since its inception, as well as the demographic characteristics of these patients.

METHODS

This study is descriptive and retrospective. We used the medical record of the patients who underwent catheter ablation (first-time and re-do procedure) in the center from July 2015 to February 2018.

RESULTS

55 catheter ablations were performed in 53 patients, who were 35 (±15) years old and 47% male. 63.6% had a full MINSA health coverage, while 16.4% and 20% had partial MINSA coverage and no health coverage, respectively. Atrio-ventricular reentrant tachycardia mediated by accessory pathways was the most common (76.4%) electrophysiology diagnosis. The overall immediate success rate was 96.4%. No complications were reported.

CONCLUSIONS

The efficacy and safety of this procedure are comparable to international standards. The main limitations might be the insufficiency of resources and inadequate diffusion of our center activity.

摘要

背景

2015年,秘鲁卫生部(MINSA)在一家公立三级转诊医院设立了首个国家电生理研究中心,旨在为服务最欠缺的人群提供医疗服务。本研究旨在描述该中心自成立以来导管消融的成功率和并发症发生率,以及这些患者的人口统计学特征。

方法

本研究为描述性回顾性研究。我们使用了2015年7月至2018年2月在该中心接受导管消融(首次及再次手术)的患者的病历。

结果

53例患者共进行了55次导管消融,患者年龄为35(±15)岁,男性占47%。63.6%的患者享有秘鲁卫生部的全面医保覆盖,而分别有16.4%和20%的患者享有部分秘鲁卫生部医保覆盖和无医保覆盖。由旁路介导的房室折返性心动过速是最常见的(76.4%)电生理诊断。总体即刻成功率为96.4%。未报告并发症。

结论

该手术的有效性和安全性与国际标准相当。主要局限性可能是资源不足以及我们中心活动的传播不足。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a69/6661456/0f95511a8678/gr1.jpg

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