针对不适当窦性心动过速/体位性正位窦性心动过速的窦房结疏散混合消融术后的心包炎预防疗法

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Heart Rhythm O2 Pub Date : 2024-02-01 DOI:10.1016/j.hroo.2024.01.001
Carlo de Asmundis MD, PhD , Lorenzo Marcon MD , Luigi Pannone MD , Domenico Giovanni Della Rocca MD, PhD , Dhanunjaya Lakkireddy MD , Thomas M. Beaver MD , Chad R. Brodt MD , Cinzia Monaco MD , Antonio Sorgente MD, PhD , Charles Audiat MD , Giampaolo Vetta MD , Robbert Ramak MSc , Ingrid Overeinder MD , Rani Kronenberger MD , Gezim Bala MD, PhD , Alexandre Almorad MD , Erwin Ströker MD, PhD , Juan Sieira MD, PhD , Andrea Sarkozy MD, PhD , Pedro Brugada MD, PhD , Mark La Meir MD, PhD
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引用次数: 0

摘要

背景心包炎是不适当窦性心动过速(IST)/体位性正位性心动过速综合征(POTS)混合窦房结保留消融术后最常见的并发症。方法回顾性分析了所有接受混合消融术的难治性或不能耐受药物的症状性 IST/POTS 患者。药物预防治疗以乙酰水杨酸和秋水仙碱为基础,从消融术当天开始,持续至少 3 个月。主要终点是出现症状性心包炎。次要终点是心包炎相关并发症的发生情况,包括以下内容:心包炎持续时间>3个月、心包炎住院、心包切除术后胸膜炎和心包切除术。结果共纳入220例接受IST/POTS混合消融术的患者,其中44例(20%)接受了预防治疗。101例(45.9%)患者发生了心包炎,其中97例(96%)发生在头5天。在生存分析中,预防性治疗与较高的心包炎治愈率相关(81.9% vs 47.2%,log-rank P <.001)。与心包炎相关的并发症较少,只有 7 例(3.2%)患者出现。接受预防性治疗的患者与未接受预防性治疗的患者在心包炎相关并发症方面没有差异。在 Cox 多变量分析中,心包炎的预测因素为 IST(vs POTS)(危险比 0.61,95% 置信区间 0.39-0.99,P = .04)和预防性治疗(危险比 0.27,95% 置信区间 0.13-0.55,P <.001)。
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Pericarditis prophylactic therapy after sinus node–sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia

Background

Pericarditis is the most common complication following hybrid sinus node–sparing ablation for inappropriate sinus tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS).

Objective

The study sought to evaluate the association of prophylaxis therapy on the risk of symptomatic pericarditis following hybrid IST/POTS ablation.

Methods

All consecutive patients undergoing to hybrid ablation of symptomatic IST/POTS refractory or intolerant to drugs were retrospectively analyzed. Pharmacological prophylaxis therapy was based on acetylsalicylic acid and colchicine started on the day of the ablation and continued for at least 3 months. The primary endpoint was occurrence of symptomatic pericarditis. The secondary endpoint was occurrence of pericarditis-related complications, including the following: duration of pericarditis >3 months, hospitalization for pericarditis, postpericardiectomy pleuro-pericarditis, and pericardiectomy.

Results

A total of 220 patients undergone to hybrid IST/POTS ablation were included and 44 (20%) underwent prophylaxis therapy. Pericarditis occurred in 101 (45.9%) patients, with 97 (96%) in the first 5 days. At survival analysis, prophylaxis was associated with higher rate of freedom from pericarditis (81.9% vs 47.2%, log-rank P < .001). Pericarditis-related complications were low, occurring in 7 (3.2%) patients. There was no difference in pericarditis-related complications between the patients who underwent prophylaxis therapy and patients who did not. At Cox multivariate analysis, predictors of pericarditis were IST (vs POTS) (hazard ratio 0.61, 95% confidence interval0.39-0.99, P = .04) and prophylaxis therapy (hazard ratio 0.27, 95% confidence interval 0.13-0.55, P < .001).

Conclusion

In a large cohort of patients undergoing hybrid ablation for IST/POTS, a prophylaxis therapy with acetylsalicylic acid and colchicine was associated with a lower rate of symptomatic pericarditis.

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来源期刊
Heart Rhythm O2
Heart Rhythm O2 Cardiology and Cardiovascular Medicine
CiteScore
3.30
自引率
0.00%
发文量
0
审稿时长
52 days
期刊最新文献
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