Gastroparesis as a Complication of Atrial Fibrillation Ablation
Gastroparesis as a Complication of Atrial Fibrillation Ablation
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DOI：
10.1016/j.amjcard.2015.03.045
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发表时间：
2015-07-01
影响因子：
2.8
通讯作者：
Erden, Ismail
中科院分区：
文献类型：
--
作者：
Aksu, Tolga;Golcuk, Sukriye;Erden, Ismail
经皮导管消融术是治疗症状性耐药房颤（AF）的安全有效的方法。胃轻瘫是房颤消融术的一种鲜为人知的并发症。我们的目的是评估通过冷冻球囊（CB）或射频（RF）接受房颤导管消融术的患者中胃轻瘫的发生率，并确定胃轻瘫的风险因素。总共有104例患者接受了2种不同技术的肺静脉（PV）隔离治疗：58例患者（第1组）采用CB，46例患者（第2组）采用开放式灌注头端射频导管。7例患者出现胃轻瘫（第1组6例，第2组1例）。第1组6例患者中有4例在手术期间开始出现胃轻瘫相关投诉。另外3名患者在术后72至96小时内因类似主诉入院。对于第1组胃轻瘫病例，下肺静脉的平均最低CB温度较低，左心房直径较小。保守治疗，患者在6个月随访时无残留症状。随访期间唯一仍显示残留症状的患者是第2组。尽管临床上明显的胃轻瘫在CB消融中很常见，但该过程通常是可逆的。然而，损伤可能不像射频消融那样可逆。总之，在冷冻消融期间，下肺静脉温度较低和左心房尺寸较小可能与胃轻瘫风险增加相关，荧光镜引导可能有助于避免这种并发症。(C)2015 Elsevier Inc. All rights reserved.
Percutaneous catheter ablation is a safe and effective treatment for symptomatic drug-resistant atrial fibrillation (AF). Gastroparesis is a little known complication of AF ablation. We aimed to evaluate the frequency of gastroparesis in the patients who underwent catheter ablation for AF by cryoballoon (CB) or radiofrequency (RF) and to define risk factors for gastroparesis. In all, 104 patients were treated with pulmonary vein (PV) isolation with 2 different technologies: CB in 58 patients (group 1) and open-irrigated tip RF catheter in 46 patients (group 2). Gastroparesis was seen in 7 cases (6 cases in group 1 and 1 case in group 2, respectively). The complaints related with gastroparesis began during the procedure in 4 of 6 patients of group 1. The other 3 patients admitted to our outpatient clinic with similar complaints within 72 to 96 hours after the procedure. For gastroparesis cases of group 1, mean minimal CB temperature on inferior PVs was lower and left atrium diameter was smaller. Management was conservative, and the patients have no residual symptoms at 6-month follow-up. The only patient still demonstrating residual symptoms during follow-up was in group 2. Although, clinically manifest gastroparesis is quite common with CB ablation, the process is generally reversible. However, damage may not be as reversible with RF ablation. In conclusion, during cryoablation, lower temperatures on inferior PVs and small left atrium size may be associated with increased risk of gastroparesis, and fluoroscopic guidance may be useful to avoid this complication. (C) 2015 Elsevier Inc. All rights reserved.