Abstract：
BACKGROUND: Pneumopericardium is a rare complication of epicardial ablation after dry pericardiocentesis to treat ventricular arrhythmia (VA); its exact clinical effects on patients are still unclear. The purpose of this study was to evaluate the clinical effects of pneumopericardium during epicardial ablation on patients with VA.
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.
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.
摘要：
背景：心包积气是干式心包穿刺术（VA）后心外膜消融术的一种罕见并发症，其对患者的确切临床效果尚不清楚。这项研究的目的是评估心外膜消融期间心包积气对VA患者的临床效果。
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。调查了心包积气的发生率。术后1年评估主要不良心血管事件（MACEs）的发生情况。
结果：本研究共纳入86例VA患者。22例心包积气,发病率为25.6%，12例（54.55％）患者在心包穿刺术后出现呼吸困难，平均发生时间为5.4±3.2分钟。血压（BP）明显下降，平均血压从119.8/73.2降至103.5/64.9mmHg(p<0.001)。所有病例均未进展为张力性气包膜。术后随访中位时间为411天，主要不良心血管事件（MACEs）的发生率，包括全因死亡的复合终点,因心力衰竭再次住院,和快速性心律失常事件，心包气组为36.4%(n=8),非心包气组为35.5%(n=23)。Kaplan-Meier生存分析显示，两组之间的MACEs发生率无统计学差异（p=0.28）。
结论：心外膜消融期间心包积气的发生率相对较高。然而,如果及早识别并管理得当，不太可能进展为张力性心包气。术中心包积气的发生可能不会显著影响患者的长期预后。
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。
