老年人心房颤动导管射频消融并发心脏压塞的临床分析

目的 探讨年龄与房颤导管消融并发心脏压塞之间的关系.方法 回顾性收集2013年1月至2016年12月在北京安贞医院行首次房颤导管射频消融术的患者,收集其围术期临床资料,分为老年组(≥60岁)和非老年组(＜60岁),利用回归模型分析老年与房颤消融心脏压塞发生的关系.结果 本研究共纳入患者5 313例,发生心脏压塞41例(...

Clinical analysis of cardiac tamponade complicating radiofrequency ablation of atrial fibrillation in elderly patients

Objective To investigate the association between age and cardiac tamponade after radiofrequency ablation of atrial fibrillation(RAAF).Methods Clinical data of patients undergone de novo AF ablation procedures at Beijing Anzhen Hospital from January 2013 to December 2016 were retrospectively collected.Patients were divided into an elderly group(age≥60 years)and a non-elderly group(age<60 years).Logistic regression analyses were used to evaluate the association between old age and the risk of cardiac tamponade complicating RAAF.Results A total of 5313 patients were involved in this study,including 41 patients(0.77%)with cardiac tamponade.The proportion of cardiac tamponade was higher in the elderly group than in the non-elderly group(1.1%or 32/2950 vs.0.4%or 9/2363,χ2=8.489,P=0.004).One patient with cardiac tamponade in the elderly group required immediate surgical repair whereas none in the non-elderly group did.No patient died in hospital.Multivariate Logistic regression analysis showed that the risk of cardiac tamponade increased in the elderly group,compared with the non-elderly group(OR=2.570,95%CI:1.190-5.570,P=0.017).Stratified analysis revealed that among females and patients with oral anticoagulants,left atrium dimension<40 mm or procedure duration≥120 min in the elderly group carried a higher risk of cardiac tamponade than those in the non-elderly group(OR=1.011,2.914,3.922 and 3.244,P<0.05).Conclusions Old age(age≥60 years)is an independent risk factor for cardiac tamponade complicating RAAF.