Pires L A, Huang S K, Wagshal A B, Mazzola F, Young P G, Moser S
Department of Medicine, University of Massachusetts Medical Center, Worcester 01655, USA.
Pacing Clin Electrophysiol. 1996 Oct;19(10):1502-7. doi: 10.1111/j.1540-8159.1996.tb03165.x.
Unsuspected cardiac complications have been occasionally identified on postablation echocardiographic studies; however, the clinical utility of route echocardiographic studies following uncomplicated radiofrequency catheter ablation procedures has not been established. Two-dimensional/Doppler echocardiographic studies obtained preablation (within 3 months of the procedure) in 355 consecutive patients (180 males and 175 females, mean age 37 +/- 21 years) were compared to postablation (within 24 hours of the procedure) studies obtained after a total of 387 uncomplicated RF catheter ablation procedures for AV node slow pathway (n = 120), accessory AV pathways (n = 214), and complete AV junction (n = 39). Postablation studies identified 6 new cases (1.5%) of new wall motion abnormalities, and 3 additional patients had septal wall motion abnormalities during ventricular pacing. LVEF remained unchanged from baseline (62 +/- 10 vs 62 +/- 11). A small pericardial effusion was detected after 11 procedures (2.8%), and there were 9 (2.3%), 21 (5.4%), and 20 (5.2%) new findings of mild (1+) aortic, mitral, and tricuspid regurgitation, respectively; and no cases of significant valvular dysfunction in any patient. There were no new cases of cavity thrombus. There was no clear relationship between postablation echocardiographic findings and the type and approach to ablation, and no patient had any clinical sequelae possibly related to any of the new echocardiographic findings during a mean follow-up of 15 +/- 6.0 months (range 1-26 months). Routine transthoracic echocardiographic studies after uncomplicated RF catheter ablation procedures identify occasional minor abnormalities that (1) may or may not be procedure related, (2) are of no apparent clinical consequence, and (3) thus appear to be of limited value.
在消融术后的超声心动图研究中偶尔会发现一些未被察觉的心脏并发症；然而，在无并发症的射频导管消融术后进行经胸超声心动图研究的临床实用性尚未确立。对355例连续患者（180例男性和175例女性，平均年龄37±21岁）在消融术前（手术3个月内）进行的二维/多普勒超声心动图研究，与在总共387例针对房室结慢径路（n = 120）、房室旁道（n = 214）和完全性房室交界区（n = 39）的无并发症射频导管消融术后（手术24小时内）进行的研究进行比较。消融术后研究发现6例新的室壁运动异常病例（1.5%），另外3例患者在心室起搏时出现间隔壁运动异常。左心室射血分数（LVEF）与基线相比无变化（62±10 vs 62±11）。11例手术（2.8%）后检测到少量心包积液，分别有9例（2.3%）、21例（5.4%）和20例（5.2%）出现轻度（1+）主动脉瓣、二尖瓣和三尖瓣反流的新发现；且无任何患者出现严重瓣膜功能障碍病例。无新的心腔内血栓病例。消融术后超声心动图检查结果与消融类型和方法之间无明确关系，在平均15±6.0个月（范围1 - 26个月）的随访期间，无患者出现任何可能与任何新的超声心动图检查结果相关的临床后遗症。在无并发症的射频导管消融术后进行常规经胸超声心动图研究可发现偶尔的轻微异常，这些异常（1）可能与手术有关，也可能无关；（2）无明显临床后果；（3）因此似乎价值有限。
