快速性心律失常射频消融术围术期穿刺部位并发症危险因素分析及处理措施
Risk factors and management measures for perioperative puncture site complications of radiofrequency ablation due to tachyarrhythmias
司会莉 1王帆 1李浩翰 1李树仁1
作者信息
- 1. 050051 石家庄,河北省人民医院心内科
- 折叠
摘要
目的 探讨影响老年快速性心律失常患者经导管射频消融术(radiofrequency catheter ablation,RFCA)后穿刺部位并发症的危险因素.方法 回顾性纳入2017年1月至2023年6月河北省人民医院心脏中心收治的行RFCA的老年快速性心律患者290例,根据住院期间术后并发症发生情况分为并发症组13例,非并发症组277例.比较2组基线临床资料,多因素logistic回归分析RFCA围术期穿刺部位并发症的独立影响因素,并绘制ROC曲线检测体质量指数对穿刺部位并发症的预测价值.结果 穿刺部位并发症在房性心律失常RFCA中较多,室上性心律失常次之,室性心律失常无,差异有统计学意义(P=0.014).与非并发症组比较,并发症组体质量指数、房性心律失常比例明显升高,差异有统计学意义(P＜0.05).2组年龄、室性心律失常、室上性心律失常、高血压、2型糖尿病等比较,差异无统计学意义(P＞0.05).多因素logistic回归分析显示,体质量指数较大是老年快速心律失常患者穿刺部位并发症的危险因素(OR=1.256,95％CI:1.032～1.528,P=0.023).ROC曲线分析显示,体质量指数预测穿刺部位并发症的曲线下面积为0.702(95％CI:0.586～0.817,P=0.018),敏感性为91.7％,特异性为49.6％,约登指数为0.413.结论 房性心律失常RFCA与穿刺部位并发症密切相关,体质量指数对穿刺部位并发症具有一定的预测价值.
Abstract
Objective To explore the risk factors for puncture site complications after radiofrequen-cy catheter ablation(RFCA)in elderly patients with tachyarrhythmias.Methods A retrospective study was conducted on 290 elderly tachyarrhythmic patients undergoing RFCA in our depart-ment from January 2017 to June 2023.According to the occurrence of postoperative complications during hospitalization,they were divided into a complication group(13 cases)and a non-complica-tion group(277 cases).The basic clinical data were compared between the two groups.Multivari-ate logistic regression analysis was used to identify the independent influencing factors for periop-erative puncture site complications in RFCA,and ROC curves were plotted to determine the pre-dictive value of BMI on puncture site complications.Results Puncture site complications were more common in atrial arrhythmia radiofrequency ablation,followed by supraventricular arrhyth-mia,and but rare in ventricular arrhythmia,with statistical difference in the incidence(P=0.014).The complication group had significantly higher BMI and larger proportion of atrial ar-rhythmias when compared with the non-complication group(P＜0.05).There were no statistical differences between the two groups in terms of age,proportions of ventricular arrhythmia,su-praventricular arrhythmia,hypertension and type 2 diabetes(P＞0.05).Multivariate logistic re-gression analysis showed that higher BMI was a risk factor for puncture site complications in eld-erly tachyarrhythmic patients after RFCA(OR=1.256,95％CI:1.032-1.528,P=0.023).ROC curve analysis indicated that the AUC value of BMI in predicting puncture site complications was 0.702(95％CI:0.586-0.817,P=0.018),with a sensitivity of 91.7％,a specificity of 49.6％,and a Yoden index of 0.413.Conclusion RFCA for atrial arrhythmias is closely associated with punc-ture site complications,and BMI has a predictive value for the complications of puncture site.
关键词
心律失常,心性/导管消融术/危险因素/并发症Key words
arrhythmias,cardiac/catheter ablation/risk factors/complications引用本文复制引用
出版年
2025
NETL
NSTL
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