METHODS: Patients with VA who underwent epicardial catheter ablation under local anesthesia at West China Hospital of Sichuan University from August 2012 to January 2022 were enrolled in this study. The incidence of pneumopericardium was investigated. The occurrence of major adverse cardiovascular events (MACEs) was evaluated 1 year after the operation.
RESULTS: A total of 86 VA patients were included in the study. Twenty-two cases had pneumopericardium, with an incidence rate of 25.6%, and 12 (54.55%) patients complained of dyspnea during the procedure with an average occurrence time of 5.4 ± 3.2 min after pericardiocentesis. The blood pressure (BP) decreased significantly, with the mean BP dropping from 119.8/73.2 to 103.5/64.9 mmHg (p < 0.001). None of the cases progressed to tension pneumopericardium. Postoperative follow-up with a median period of 411 days showed that the incidence rate of major adverse cardiovascular events (MACEs), including the composite endpoints of all-cause death, rehospitalization for heart failure, and tachyarrhythmia events, was 36.4% (n = 8) in the pneumopericardium group and 35.5% (n = 23) in the non-pneumopericardium group. The Kaplan-Meier survival analysis showed that there was no statistically significant difference in the incidence of MACEs between the two groups (p = 0.28).
CONCLUSIONS: The incidence of pneumopericardium during epicardial ablation was relatively high. However, if recognized early and managed properly, it is unlikely to progress to tension pneumopericardium. The occurrence of pneumopericardium during the procedure may not significantly affect the long-term prognosis of patients.
方法:2012年8月至2022年1月在四川大学华西医院局麻下行心外膜导管消融术的VA患者。
结果:本研究共纳入86例VA患者。
结论:心外膜消融期间心包积气的发生率相对较高。