介入治疗膜周部室间隔缺损后早期的心律失常

目的探讨介入治疗膜周部室间隔缺损后早期心律失常的特点。方法回顾性分析膜周部室间隔缺损273例心电图资料，了解介入封堵术后早期发生的各种类型心律失常。分析封堵器类型、缺损大小及有无膜部瘤对心律失常发生的影响。结果心律失常发生率33．0％（90／273），其中传导阻滞占68．9％（62／90）。国产和进口封堵器组的心律失常差异无统计学意义（P〉0．05）；室间隔缺损小于5mm组和不小于5mm组的心律失常发生率分别为25．8％、49．4％（P〈0．05）。结论膜周部室间隔缺损介入治疗后早期心律失常发生率较高，以传导阻滞为主。室间隔缺损大小和有无膜部瘤是影响术后早期心律失常的重要因素。

Early arrhythmia after transcatheter closure of perimembranous ventricular septal defect

Objectives To analyze the characteristics of early arrhythmia after transcatheter closure of perimembranous ventricular septal defect （PVSD）. Methods Early arrhythmia after transcatheter closure treatment was analyzed retrospectively in 273 PVSD patients. All the patients were divided into several groups according to type of occluders, size of defects, or complication of membranous ventricular septal aneurysm （MVSA） , and arrhythmia in these groups was compared to estimate the effect of the above factors on the development of early arrhythmia. Results The incidence rate of early arrhythmia was 33.0% （90/273） and conduction blockade occupied 68.9% （62/90）. There was no statistical difference in arrhythmia between domestic occluder and Amplatzer （P〉0.05）. There was statistical difference in arrhythmia rate （25.8% vs. 49.4%, P〈0.05）, and in conduction blockade rate （ 16.8% vs. 36.2%, P〈0.05） between defect size less than 5 mm group and not less than 5 mm group. There was statistical difference between the groups with or without MVSA in atrial ventricular block rate （6.2% vs. 0.96%, P〈0.05）. Conclusions Early arrhythmia after transcatheter closure occurs frequently in PVSD patients, most of which belongs to conduction blockade. The size of ventricular septal defect and complication of MVSA play important roles in the development of early arrhythmia after intervention.