X线引导下左心耳封堵联合导管消融术的有效性和安全性分析
The effectiveness and safety of X-ray guided left atrial appendage occlusion combined with catheter ablation
罗阳 1胥良 2王琰 2赵育洁2
作者信息
- 1. 新乡医学院(河南新乡,453003)
- 2. 郑州市第七人民医院心内科;河南省心律失常医学重点实验室
- 折叠
摘要
目的:评估X线引导下左心耳封堵联合导管消融术的有效性和安全性.方法:纳入2017年3月-2022年4月在郑州市第七人民医院住院并接受导管消融的非瓣膜性心房颤动(房颤)患者,通过倾向性评分匹配,分为经食管超声心动图联合X线组(TEE组,73例)和单用X线组(DSA组,73例).随访12个月,比较两组围手术期与随访期资料,评估单用X线指导左心耳封堵联合导管消融术的有效性、安全性以及经济效益.结果:两组患者均成功完成导管消融和左心耳封堵.DSA组少量心包积液事件发生率(20.5％vs 8.2％)、住院时间[(10.5±2.7)d vs(9.3±2.6)d]和住院花费[(156 517.7±13 271.2)元 vs(146 028.1±12 481.1)元]均显著低于 TEE 组(均 P＜0.05).两组随访期间终点事件发生率均差异无统计学意义.结论:对于左心耳封堵联合导管消融,X线单独引导的有效性和安全性并不劣于X线联合经食管超声心动图,且在减少住院花费和住院时间上具有一定的优势.
Abstract
Objective:To explore the effectiveness and safety of X-ray guided left atrial appendage occlusion combined with catheter ablation.Methods:Patients with non-valvular atrial fibrillation who underwent catheter ablation and were admitted to the 7th People's Hospital of Zhengzhou from March 2017 to April 2022 were includ-ed.These patients were divided into the transesophageal echocardiography combined with X-ray group(TEE group,n=73)and the X-ray group(DSA group,n=73)using propensity score matching.Followed up for 12 months,perioperative and follow-up data were compared between the two groups,the effectiveness,safety,and economic benefits of using X-ray guidance alone for left atrial appendage occlusion combined with catheter ablation were evaluated.Results:Patients in both groups successfully completed catheter ablation and left atrial appendage occlusion.The incidence of small pericardial effusion(20.5％vs 8.2％),hospitalization duration[(10.5±2.7)d vs(9.3±2.6)d],and expenses[¥(156 517.7±13 271.2)vs ¥(146 028.1±12 481.1)]in the DSA group were significantly lower than those in the TEE group(all P＜0.05).There was no statistically significant difference in the incidence of endpoint events during the followup period between the two groups.Conclusion:For left atrial ap-pendage occlusion combined with catheter ablation,the effectiveness and safety of X-ray guidance alone are not in-ferior to that of X-ray combined with transesophageal echocardiography guidance,and it has certain advantages in reducing hospitalization costs and length of stay.
关键词
导管消融/左心耳封堵/数字减影血管造影术/倾向评分匹配Key words
catheter ablation/left atrial appendage occlusion/digital subtraction angiography/propensity score matching引用本文复制引用
基金项目
河南省科技攻关计划(222102310667)
郑州市名医支持项目(2021)(5)
郑州市科技惠民项目(2022)(2022KJHM0033)
河南省自然科学基金(212300410305)
出版年
2024
NETL
NSTL
万方数据