Association between the use of contact force-sensing catheters and cardiac tamponade in atrial fibrillation ablation
Association between the use of contact force-sensing catheters and cardiac tamponade in atrial fibrillation ablation
复制标题
房颤消融中接触力传感导管的使用与心包填塞之间的关联
DOI：
10.1007/s10840-019-00516-z
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发表时间：
2019-08-01
影响因子：
1.8
通讯作者：
Ma, Changsheng
中科院分区：
文献类型：
--
作者：
Liu, Nian;Zhao, Qianqian;Ma, Changsheng
心脏压塞是房颤(AF)导管消融术中一种罕见但危及生命的并发症。接触力(CF)感应型导管可提高消融效果。然而，应用CF敏感导管对心脏压塞发生的影响尚不清楚。本研究的目的是在一家经验丰富的医疗中心评估CF敏感导管对房颤消融时心脏压塞的实际影响。方法和结果：这是北京安贞医院2013-2016年间连续房颤消融手术的回顾性研究。消融术分为CF组和非CF组。采用Logistic回归分析评价CF敏感导管的使用与心脏压塞风险之间的关系。本研究共纳入5313例房颤患者。心衰组心脏压塞发生率为1.07%，明显高于非心衰组的0.44%(P=0.009)。非心力衰竭组心脏压塞延迟发生率为45.45%，心力衰竭组为10%(P=0.011)。多因素Logistic回归分析显示，CF敏感导管可增加心包填塞的危险性(OR=2.34，95%CI=1.17~4.26，P=0.015)。分层分析显示，左房内径较小、射血分数较低、手术时间较长或消融时间较长的患者在使用CF敏感导管消融时发生心脏压塞的风险更大。
IntroductionCardiac tamponade is a rare but life-threatening complication during atrial fibrillation (AF) catheter ablation. Contact force (CF)-sensing catheters improve ablation effectiveness. However, the impact of the application of CF-sensing catheters on the occurrence of cardiac tamponade remains unclear. The aim of this study is to evaluate the real-world impact of CF-sensing catheters on cardiac tamponade during AF ablation in an experienced medical center.Methods and resultsThis was a retrospective study of consecutive de novo AF ablation procedures at Beijing Anzhen Hospital between 2013 and 2016. The ablation procedure was divided into a CF group and a non-CF group. Logistic regression analysis was used to evaluate the association between the use of CF-sensing catheters and the risk of cardiac tamponade. A total of 5313 patients with AF were involved in this study. The incidence of cardiac tamponade in the CF group was significantly higher than that in the non-CF group (1.07% vs. 0.44%, P=0.009). Of the cardiac tamponade cases in the non-CF group, 45.45% were delayed compared with 10% in the CF group (P=0.011). Multivariate logistic regression analysis showed that CF-sensing catheters increased the risk of cardiac tamponade (OR=2.34, 95% CI=1.17-4.26, P=0.015). Stratified analysis revealed patients with a smaller left atrium dimension, lower ejection fraction, longer procedure duration, or longer ablation duration had a greater risk of cardiac tamponade during ablation with CF-sensing catheters.ConclusionsCF-sensing catheters increase the risk of cardiac tamponade during AF ablation.