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年龄对室性早搏导管消融的影响。

Impact of age on catheter ablation of premature ventricular contractions.

机构信息

Department of Cardiology, Medical University of South Carolina, Charleston, USA.

Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.

出版信息

J Cardiovasc Electrophysiol. 2021 Apr;32(4):1077-1084. doi: 10.1111/jce.14976. Epub 2021 Mar 13.

Abstract

INTRODUCTION

Catheter ablation (CA) of frequent premature ventricular contractions (PVC) is increasingly performed in older patients as the population ages. The aim of this study was to assess the impact of age on procedural characteristics, safety and efficacy on PVC ablations.

METHODS

Consecutive patients with symptomatic PVCs undergoing CA between 2015 and 2020 were evaluated. Acute ablation success was defined as the elimination of PVCs at the end of the procedure. Sustained success was defined as an elimination of symptoms, and ≥80% reduction of PVC burden determined by Holter-electrocardiogram during long-term follow. Patients were sub-grouped based on age (<65 vs. ≥65 years).

RESULTS

A total of 114 patients were enrolled (median age 64 years, 71% males) and followed up for a median duration of 228 days. Baseline and procedural data were similar in both age groups. A left-sided origin of PVCs was more frequently observed in the elderly patient group compared to younger patients (83% vs. 67%; p = .04). The median procedure time was significantly shorter in elderly patients (160 vs. 193 min; p = .02). The rates of both acute (86% vs. 92%; p = .32) and sustained success (70% vs. 71%; p = .90) were similar between groups. Complications rates (3.7%) did not differ between the two groups.

CONCLUSION

In a large series of patients with a variety of underlying arrhythmia substrates, similar rates of acute procedural success, complications, and ventricular arrhythmia-free-survival were observed after CA of PVCs. Older age alone should not be a reason to withhold CA of PVCs.

摘要

简介

随着人口老龄化,导管消融(CA)治疗频发室性早搏(PVC)在老年患者中的应用越来越多。本研究旨在评估年龄对 PVC 消融术的程序特征、安全性和疗效的影响。

方法

连续评估了 2015 年至 2020 年间因症状性 PVC 而行 CA 的患者。急性消融成功定义为在手术结束时消除 PVC。持续性成功定义为消除症状和通过长时间 Holter 心电图确定 PVC 负荷减少≥80%。根据年龄(<65 岁与≥65 岁)将患者分为亚组。

结果

共纳入 114 例患者(中位年龄 64 岁,71%为男性),中位随访时间为 228 天。两组患者的基线和程序数据相似。与年轻患者相比,老年患者的 PVC 起源更倾向于左侧(83% vs. 67%;p=0.04)。老年患者的中位手术时间明显缩短(160 分钟 vs. 193 分钟;p=0.02)。两组急性成功率(86% vs. 92%;p=0.32)和持续性成功率(70% vs. 71%;p=0.90)相似。两组并发症发生率(3.7%)无差异。

结论

在一组具有多种潜在心律失常基质的患者中,PVC 的 CA 后观察到急性程序成功率、并发症和室性心律失常无复发生存率相似。单纯年龄增长不应成为拒绝行 PVC CA 的理由。

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