Incidence,risk factors and management of pericardial effusion post radiofrequency catheter ablation in patients With atrial fibrillations
10.3321/j.issn:0253-3758.2008.09.009
- VernacularTitle:心房颤动射频消融术后心包积液的处理及危险因素分析
- Author:
Song-Wen CHEN
1
;
Shao-Wen LIU
;
Jia-Xiong LIN
;
Zhen-Ning NIE
;
Bao-Zhen QI
;
Hui-Wei TAO
;
Hong-Yi WU
;
Kuan CHENG
;
Jun-Bo GE
Author Information
1. 上海市第一人民医院
- Keywords:
Atrial fibrillation;
Catheter ablation;
Pericardial effusion;
Rrisk factors
- From:
Chinese Journal of Cardiology
2008;36(9):801-806
- CountryChina
- Language:Chinese
-
Abstract:
Objective Pericardial effusion (PE) is a major complieation of atrial fibriuation ablation(AFB).We analyzed the incidence,risk factors and managements of PE post AFB(radiofrequency catheter ablation).Methods A total of 156 consecutive patients with AF [ male 108,paroxysmal AF 114, (57.6±11.3)years],who underwent AFB guided by a three-dimensional mapping system (CARTO or CARTO-Merge,Biosense-Webster Inc.Diamond Bar,California) and a circular mapping catheter(Lasso, Biosense-Webster Inc.Diamond Bar.California),were included in this study.The ablation strategy included Circumferential pulmonary veins isolation (CPVI).linear ablation and/or complex fraetionated atrial electrograms (CFAEs) ablation.Electrophysiologieal data and vital signs of patients were recorded by a multiple physiological recorder (Prueka,GE Medical System) during ablation.Ablation process,sites,duration and other related factors wen als0 recorded. Eehocardiography and other examinations were performed for diagnosing and monitoring PE.Results CPVl were achieved in all 156 patients.Incidenee of PE Was 10.3%(16/156)post AFB.One patient developed acute cardiac tamponade and emergency drainage of the perieardial effusion was performed through a median stemotomy and patient recovered without eomplieations during the 18 months f0U0w-up.The rest 15 PE patients with small PE received outpatient care and no invaBive treatment wag needed and PE disappeared after 3 months in 6 patients and after 6 months in 9 patients.Univariate analysis showed that the composition of gender(P<0.01).ablation in coronary sinus (CS,P=0=026),ablation of CFAEs(P=0.037) and superior vena cava(SVC,P=0.041)were risk factors for PE.Logistic regression analysis showed that hmMe gender [β=3.594,exp(b)=36.4,95% confidence interval(Cl):4.2-312.1,P=0.001] and ablation in CS [β=2.419,exp(b)=11.2, 95%cl:1.0-124.6,P=0.049] were independent risk factors for PE post AFB.Conclusions PE iS a common complication of AFB,female gender and ablation in CS were independent risk factors for PE.Most PE patients experienced spontaneous recovery but emergency treatment Wag needed for patient with cardiac tamponade.
