Manchester Heart Centre, Manchester University NHS Foundation Trust, Manchester, UK.
Manchester Heart Centre, Manchester University NHS Foundation Trust, Manchester, UK; Division of Cardiovascular Sciences within the School of Medicine, University of Manchester, Manchester, UK.
Heart Lung Circ. 2022 Jul;31(7):1015-1022. doi: 10.1016/j.hlc.2022.01.014. Epub 2022 Mar 14.
Cardiac catheter ablations are an established treatment for supraventricular tachycardia (SVT) involving prolonged cannulation of the common femoral vein with multiple catheters. This study aimed to identify the risk of deep vein thrombosis (DVT) by studying the frequency of this complication after catheter ablation.
This was a prospective multi-centre cohort study of patients undergoing cardiac ablation for atrioventricular nodal re-entry tachycardia or right-sided accessory atrioventricular connection. Those taking anticoagulation or antiplatelet therapy prior to the procedure were excluded. Following the procedure, bilateral venous duplex ultrasonography from the popliteal vein to the inferior vena cava for DVT was undertaken at 24 hours and between 10 to 14 days.
Eighty (80) patients (mean age 47.6 yrs [SD 13.4] with 67% female) underwent cardiac ablation (median duration 70 mins). Seven (7) patients developed acute DVT in either the femoral or external iliac vein of the intervention leg, giving a frequency of 8.8% (95% CI 3.6-17.2%). No thrombus was seen in the contralateral leg (p=0.023). An elevated D-dimer prior to the procedure was significantly more frequent in patients developing DVT (42.9% vs 4.1%, p=0.0081; OR 17.0). No other patient or procedural characteristics significantly influenced the risk of DVT.
In patients without peri-procedural anticoagulation catheter ablation precipitated DVT in the catheterised femoral or iliac veins in 8.8% of patients. Peri-procedure prophylactic anticoagulation may be considered for all patients undergoing catheter ablation for SVT.
心脏导管消融术是治疗涉及股总静脉长时间置管和多个导管的室上性心动过速（SVT）的一种既定治疗方法。本研究旨在通过研究导管消融后这种并发症的发生频率，来确定深静脉血栓形成（DVT）的风险。
这是一项针对房室结折返性心动过速或右侧附加房室连接行心脏消融术的患者的前瞻性多中心队列研究。排除术前接受抗凝或抗血小板治疗的患者。术后 24 小时和 10-14 天，对双侧股静脉至下腔静脉行静脉双功超声检查以排除 DVT。
80 例（平均年龄 47.6 岁[SD 13.4]，女性占 67%）患者接受了心脏消融术（中位时间 70 分钟）。7 例（7%）患者在介入侧的股静脉或髂外静脉中出现急性 DVT，发生率为 8.8%（95%CI 3.6-17.2%）。对侧下肢未见血栓（p=0.023）。术前 D-二聚体升高的患者发生 DVT 的比例明显更高（42.9% vs 4.1%，p=0.0081；OR 17.0）。没有其他患者或手术特征显著影响 DVT 的风险。
在无围手术期抗凝的患者中，导管消融术可导致 8.8%的患者在置管的股静脉或髂静脉中发生 DVT。所有接受 SVT 导管消融术的患者均可考虑预防性抗凝。
