摘要
目的 比较房颤射频消融术中房间隔穿刺应用单、双鞘管继发ST段抬高的发生率的及临床特征。方法 回顾分析安庆市立医院2008年1月—2022年11月行房颤射频消融术患者1 132例临床资料,其中单鞘管房间隔穿刺组589例,双鞘管房间隔穿刺组543例,比较2组在房间隔穿刺后出现ST段抬高发生率、伴随临床症状程度(严重、中度、轻度、微症状)和临床症状期间最低收缩压(systolic blood pressure,SBP)、最低舒张压(diastolic blood pressure,DBP)、最低心率(heart rate,HR)以及其持续时间(发生2次ST段抬高患者记录临床症状较重时上述参数)等。结果 2组年龄、糖尿病史及左房容积指数差异有统计学意义(χ^(2)=3.926、6.629、7.709,P<0.001、0.010、<0.001)。单鞘管组中7例在房间隔穿刺术时出现ST段抬高(1.19%),双鞘管组中17例在房间隔穿刺术时出现ST段抬高(3.13%),差异有统计学意义(χ^(2)=5.136,P=0.02);单鞘管组最低SBP、最低DBP、最低HR以及持续时间与双鞘管组比较差异均有统计学意义(t=6.176、4.845、5.958、4.923,P均<0.001)。结论 在房颤射频消融术中,ST段抬高是经房间隔穿刺期间并不少见的临床现象,且房间隔穿刺应用双鞘管较单鞘管可增强ST段抬高发生率以及带来一定临床风险。
Objective To compare the incidence and characteristics of ST segment elevation secondary to transseptal puncture with single or double sheath in radiofrequency ablation of atrial fibrillation.Methods The clinical data of 1132 patients who had undergone radiofrequency ablation of atrial fibrillation in Anqing Municipal Hospital between January 2008 and November 2022,including 589 patients in the single sheath transseptal puncture group and 543 patients in the double sheath transseptal puncture group,was retrospectively studied.The incidence of ST-segment elevation,severity of clinical symptoms(severe,moderate,mild and slight),minimum systolic blood pressure(mmHg),minimum diastolic blood pressure(mmHg),minimum heart rate(bpm)and duration(min)of ST-segment elevation in the two groups after transseptal puncture were statistically analyzed.Results There were significant differences in age,diabetes history and left atrial volume index between the two groups(χ^(2)=3.926,6.629,7.709,P<0.001,0.010,<0.001).7 patients in the single sheath group had ST segment elevation during transseptal puncture(1.19%),compared with 17 in the double sheath group(3.13%)(χ^(2)=5.136,P=0.023).The minimum systolic blood pressure,minimum diastolic blood pressure,minimum heart rate and duration in the single sheath group were significantly different in the double sheath group(t=6.176,4.845,5.958,4.923,P all<0.001).Conclusion In of atrial fibrillation,ST-segment elevation is not a rare clinical phenomenon during transseptal puncture,and the application of double-sheath in transseptal puncture can enhance the incidence of ST-segment elevation and raise clinical risks compared with single sheath.
作者
朱贤关
陈良川
乔锐
郑元喜
项学军
ZHU Xianguan;CHEN Liangchuan;QIAO Rui;ZHENG Yuanxi;XIANG Xuejun(Department of Cardiology,Anqing Municipal Hospital,Anqing 246003,China)
出处
《空军航空医学》
2023年第4期327-330,共4页
AVIATION MEDICINE OF AIR FORCE
基金
安徽医科大学校科研基金(2018xkj075)。
关键词
房颤
射频消融术
房间隔穿刺
ST段抬高
Atrial fibrillation
Radiofrequency ablation
Transseptal puncture
ST segment elevation
