CAJ | 학술논문

目的对心房颤动(房颤)导管消融术的并发症情况进行探讨.方法 2006年5月至2011年12月完成房颤导管消融术402例,其中阵发性房颤300例,持续及长期持续性房颤102例,男237例,女165例,年龄26～85(61.3±8.5)岁.阵发性房颤采用环肺静脉消融术式,部分病例结合神经节消融,持续及长期持续性房颤在环肺静脉消融基础上,采用递进式消融策略.对并发症情况进行回顾性分析.结果 402例房颤消融术中,共发生并发症23例,发生率为5.7％,其中心脏穿孔/压塞5例(1.2％)、膈神经损伤3例(0.7％)、脑动脉栓塞2例(0.5％)、肺动脉栓塞合并死亡1例(0.2％)、血胸1例(0.2％)、血管穿刺部位血肿7例(1.7％)、动-静脉瘘1例(0.2％)、假性动脉瘤3例(0.7％),无肺静脉狭窄及心房-食管瘘发生.结论房颤导管消融术存在的并发症情况应引起足够重视.
목적 대심방전동(방전)도관소융술적병발증정황진행탐토.방법 2006년5월지2011년12월완성방전도관소융술402례,기중진발성방전300례,지속급장기지속성방전102례,남237례,녀165례,년령26～85(61.3±8.5)세.진발성방전채용배폐정맥소융술식,부분병례결합신경절소융,지속급장기지속성방전재배폐정맥소융기출상,채용체진식소융책략.대병발증정황진행회고성분석.결과 402례방전소융술중,공발생병발증23례,발생솔위5.7％,기중심장천공/압새5례(1.2％)、격신경손상3례(0.7％)、뇌동맥전새2례(0.5％)、폐동맥전새합병사망1례(0.2％)、혈흉1례(0.2％)、혈관천자부위혈종7례(1.7％)、동-정맥루1례(0.2％)、가성동맥류3례(0.7％),무폐정맥협착급심방-식관루발생.결론 방전도관소융술존재적병발증정황응인기족구중시.
Objective To investigate the incidence of complications during catheter ablation for atrial fibrillation(AF).Methods A total of 402 AF patients[(61.3±8.5)years,237 males] who received catheter ablation in our hospital from May 2006 to December 2011 were enrolled,including 300 patients with paroxysmal AF(PAF) and 102 patients with persistent or long-standing persistent AF.Circumferential pulmonary vein ablation(CPVA) was performed in patients with paroxysmal AF,and some PAF patients also received catheter ablation of ganglionated plexi.Patients with persistent or long-standing persistent AF underwent CPVA and stepwise ablation approach.Complications occurred in 23 cases and were retrospectively analyzed.Results The incidence of complications during catheter ablation for AF was 5.7％ (23 of 402 patients),including 5 (1.2％)cases of cardiac perforation or cardiac tamponade,3 (0.7 ％) cases of phrenic nerve injury,2 (0.5 ％) cases of cerebral embolism,1 (0.2％)case of death due to aggravated pulmonary embolism,1 (0.2％)case of haemothorax,7(1.7％) cases of hematoma at puncture site,1 (0.2％) case of arteriovenous fistula and 3 (0.7％) cases of pseudoaneurysm.No complications of pulmonary vein stenosis and esophageal fistula were found.Conclusions Complications of catheter ablation for AF should cause enough attention.