Experimental efficacy of pericardial instillation of anti-inflammatory agents during percutaneous epicardial catheter ablation to prevent postprocedure pericarditis.
Experimental efficacy of pericardial instillation of anti-inflammatory agents during percutaneous epicardial catheter ablation to prevent postprocedure pericarditis.
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经皮心外膜导管消融期间心包滴注抗炎药预防术后心包炎的实验效果。
DOI：
10.1111/j.1540-8167.2007.00945.x
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发表时间：
2007
影响因子：
2.7
通讯作者：
Reddy,VivekY
中科院分区：
文献类型：
--
作者：
d'Avila,Andre;Neuzil,Petr;Thiagalingam,Aravinda;Gutierrez,Paulo;Aleong,Ryan;Ruskin,JeremyN;Reddy,VivekY
简介：心包炎是基于导管的经皮心外膜标测和消融的潜在并发症。本研究评估了在猪术后心包炎模型中进行心包标测和消融后心包内灌注抗炎剂的有效性和安全性。方法和结果：25只健康猪在经胸剑突下穿刺后进行了心外膜标测和消融。在心包腔内连续操作导管60分钟后，以线性方式将射频能量输送至两个心房的心外膜表面。将动物随机分为接受抗炎剂、透明质酸和曲安西龙或对照。消融后14天，切除心脏，并对心包反应/粘连程度进行评分。所有对照动物的严重度均为4级（严重），其特征为壁层和心包脏层之间的严重粘连，使组织平面和心外膜解剖结构模糊。羟乙磺酸提供了轻微的益处（评分3.0 ± 0.9），但2 mg/kg的曲安奈德显著减弱了炎症效应（所有动物的评分均为1.0）。结论：在消融相关心包炎的猪模型中，心包内滴注2 mg/kg的中效皮质类固醇可有效防止术后炎性粘连形成。
Introduction:Pericarditis is a potential complication of catheter‐based percutaneous epicardial mapping and ablation. This study evaluates the efficacy and safety of intrapericardial instillation of anti‐inflammatory agents after pericardial mapping and ablation in a porcine model of postprocedural pericarditis.Methods and Results:Twenty‐five healthy swine underwent epicardial mapping and ablation after transthoracic subxyphoid puncture. After 60 minutes of continuous catheter manipulation in the pericardial space, radiofrequency energy was delivered in a linear fashion to the epicardial surfaces of both atria. The animals were randomly divided to receive the anti‐inflammatory agents, Hyaluronic Acid and Triamcinolone, or control. Fourteen days after ablation, the hearts were excised and the degree of pericardial reaction/adhesions scored. The severity was uniformly graded 4 (intense) in all control animals and was characterized by intense adhesion between the parietal and the visceral pericardium obscuring tissue planes and epicardial anatomy. Hyaluronic Acid provided a mild benefit (score 3.0 ± 0.9), but 2 mg/kg of Triamcinolone significantly attenuated the inflammatory effect (all animals uniformly scored 1.0).Conclusion:In a porcine model of ablation‐related pericarditis, intrapericardial instillation of 2 mg/kg of intermediate‐acting corticosteroids effectively prevents post‐procedure inflammatory adhesion formation.
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