Deshpande Saurabh, Swatari Hiroyuki, Ahmed Raheel, Collins George, Khanji Mohammed Y, Somers Virend K, Chahal Anwar A, Padmanabhan Deepak
Jayadeva Institute of Cardiac Sciences and Research Bangalore India.
Department of Cardiovascular Diseases Mayo Clinic Rochester Minnesota USA.
J Arrhythm. 2023 Aug 30;39(5):790-798. doi: 10.1002/joa3.12911. eCollection 2023 Oct.
Cardiac tamponade (CT) can be a complication following invasive cardiac procedures. We assessed CT following common cardiac electrophysiology (EP) procedures to facilitate risk prediction of associated morbidity and in-hospital mortality.
Patients who underwent various EP procedures in the cardiac catheterization lab (ablations and device implantations) were identified using the International Classification of Diseases, Ninth and Tenth Edition, Clinical Modification (ICD-9-CM and ICD-10-CM, respectively) from the Nationwide Inpatient Sample (NIS) database. Patient demographics, presence of comorbidities, CT-related events, and in-hospital death were also abstracted from the NIS database.
The frequency of CT-related events in patients with EP intervention from 2010 to 2017 ranged from 3.4% to 7.0%. In-hospital mortality related to CT-related events was found to be 2.2%. Increasing age was the only predictor of higher mortality in atrial fibrillation (AF) ablation and cardiac resynchronization therapy (CRT) groups (OR [95% CI]: AF ablation = 11.15 [1.70-73.34], = .01; CRT = 1.41 [1.05-1.90], = .02).
In the real-world setting, CT-related events in EP procedures were found to be 3.4%-7.0% with in-hospital mortality of 2.2%. Older patients undergoing AF ablation were found to have higher mortality.
心脏压塞（CT）可能是侵入性心脏手术的一种并发症。我们评估了常见心脏电生理（EP）手术后的CT情况，以促进对相关发病率和院内死亡率的风险预测。
使用来自全国住院患者样本（NIS）数据库的国际疾病分类第九版和第十版临床修订本（分别为ICD - 9 - CM和ICD - 10 - CM），识别在心脏导管实验室接受各种EP手术（消融和器械植入）的患者。患者人口统计学特征、合并症情况、与CT相关的事件以及院内死亡情况也从NIS数据库中提取。
2010年至2017年接受EP干预的患者中，与CT相关事件的发生率在3.4%至7.0%之间。发现与CT相关事件相关的院内死亡率为2.2%。年龄增加是心房颤动（AF）消融和心脏再同步治疗（CRT）组中较高死亡率的唯一预测因素（OR [95% CI]：AF消融 = 11.15 [1.70 - 73.34]，P = 0.01；CRT = 1.41 [1.05 - 1.90]，P = 0.02）。
在现实世界中，EP手术中与CT相关的事件发生率为3.4% - 7.0%，院内死亡率为2.2%。接受AF消融的老年患者死亡率较高。
