Wang Hanzhi, Cheng Jifang, Chen Qi, Pu Zhaoxia, Li Huajun
Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China.
J Cardiothorac Surg. 2024 Jul 16;19(1):454. doi: 10.1186/s13019-024-02934-1.
The feasibility of percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) for the treatment of hypertrophic obstructive cardiomyopathy (HOCM) has been previously reported. However, limited investigation has been conducted regarding the complications associated with this procedure.
This study aims to analyze the risk factors affecting the occurrence of complications during PIMSRA, such as pericardial effusion, ventricular premature beats, and interventricular septal perforation. In this study, the optimal cut-off values for these risk factors are also explored, and corresponding strategies for prevention are proposed.
A total of 101 patients diagnosed with HOCM who underwent the PIMSRA procedure from 2021 to 2022 were included in this retrospective analysis. Patients were classified into subgroups with or without complications based on procedural records. Univariate and multivariate regression analyses were conducted to identify independent risk factors for complications during the PIMSRA procedure.
There were 48 patients with complications and 53 patients without complications. The heart rate at the start of the procedure and the maximum left ventricular outflow tract gradient (LVOTG) were independent risk factors related to PIMSRA complications. The optimal cut-off values for predicting complication occurrence were a heart rate > 49 bpm at the start of the procedure (OR: 3.79, 95% CI: 1.64-8.78, p = 0.002) and a maximum LVOTG > 92 mmHg (OR: 2.57, 95% CI: 1.15-5.75, p = 0.022), respectively.
The occurrence of PIMSRA complications is primarily associated with the heart rate at the start of the procedure and the maximum LVOTG. It is recommended to establish a comprehensive control plan to minimize the risk of complications during PIMSRA procedures.
经皮心肌间隔射频消融术（PIMSRA）治疗肥厚性梗阻性心肌病（HOCM）的可行性此前已有报道。然而，关于该手术相关并发症的研究较少。
本研究旨在分析影响PIMSRA手术期间并发症发生的危险因素，如心包积液、室性早搏和室间隔穿孔。本研究还探讨了这些危险因素的最佳截断值，并提出了相应的预防策略。
本回顾性分析纳入了2021年至2022年期间接受PIMSRA手术的101例确诊为HOCM的患者。根据手术记录将患者分为有并发症和无并发症的亚组。进行单因素和多因素回归分析，以确定PIMSRA手术期间并发症的独立危险因素。
48例患者出现并发症，53例患者未出现并发症。手术开始时的心率和最大左心室流出道梯度（LVOTG）是与PIMSRA并发症相关的独立危险因素。预测并发症发生的最佳截断值分别为手术开始时心率>49次/分（OR：3.79，95%CI：1.64-8.78，p=0.002）和最大LVOTG>92 mmHg（OR：2.57，95%CI：1.15-5.75，p=0.022）。
PIMSRA并发症的发生主要与手术开始时的心率和最大LVOTG有关。建议制定全面的控制计划，以降低PIMSRA手术期间并发症的风险。
