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Clinical characteristics and risk factors of pericardial effusion complicating radiofrequency catheter ablation in Chinese Han patients with tachyarrhythmias

Klinische Merkmale und Risikofaktoren des Perikardergusses als Komplikation der Radiofrequenz-Katheterablation bei Han-Chinesen mit Tachyarrhythmie

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Abstract

Background

The clinical features and risk factors of pericardial effusion complicating radiofrequency catheter ablation (RFCA) in a large sample of Chinese Han patients with tachyarrhythmias have rarely been reported.

Methods

We summarized the clinical characteristics and analyzed the risk factors of pericardial effusion complicating RFCA in 1,756 Chinese Han patients with tachyarrhythmias.

Results

There were 27 patients with pericardial effusion after RFCA. Of these patients, 10 developed cardiac tamponade; the symptoms of 9 patients were relieved after pericardiocentesis and drainage, while 1 patient was discharged after emergency surgical repair. The rate of pericardial effusion in patients with atrial fibrillation was significantly higher than in those with other tachyarrhythmias (P < 0.001). The proportion of female patients, hypertension, diabetes mellitus, coronary heart disease, age, left atrial size, and length of hospitalization in the pericardial effusion group was significantly increased compared with the non-pericardial effusion group (P < 0.01). Multivariate logistic regression analysis showed that female sex and atrial fibrillation were independent risk factors of complications by pericardial effusion after RFCA in patients with tachyarrhythmias. Age and left atrial size in female patients and those with atrial fibrillation were significantly higher than in male patients and patients without atrial fibrillation.

Conclusion

Pericardial effusion complicating RFCA is not rare in patients with tachyarrhythmias, and it tends to develop into cardiac tamponade. Emergency pericardiocentesis and drainage are the most effective therapy. Female sex and atrial fibrillation may be independent risk factors of pericardial effusion after RFCA in patients with tachyarrhythmias.

Zusammenfassung

Hintergrund

Selten wird über die klinischen Merkmale und Risikofaktoren des Perikardergusses als Komplikation einer Radiofrequenz-Katheterablation (RFCA) in größeren Stichproben von Han-Chinesen mit Tachyarrhythmie berichtet.

Methoden

In der vorliegenden Studie wurden die klinischen Merkmale von 1756 Han-Chinesen mit Tachyarrhythmie zusammengefasst und deren Risikofaktoren für einen Perikarderguss als Komplikation einer RFCA ausgewertet.

Ergebnisse

Nach RFCA trat in 27 Fällen ein Perikarderguss auf, bei 10 Fällen davon entwickelte sich eine Herzbeuteltamponade, in 9 Fällen besserten sich die Symptome nach Perikardpunktion und -drainage, während ein Fall nach einer Notfalloperation entlassen wurde. Die Rate an Perikardergüssen war bei Patienten mit Vorhofflimmern signifikant höher als bei Patienten mit anderen Tachyarrhythmien (p < 0,001). Bei der Gruppe mit Perikarderguss waren gegenüber der Gruppe ohne Perikarderguss Frauen, Hypertonie, Diabetes mellitus und koronare Herzkrankheit signifikant häufiger, Alter, Größe des linken Vorhofs und Verweildauer signifikant erhöht (p < 0,01). Die multivariate logistische Regressionsanalyse zeigte, dass weibliches Geschlecht und Vorhofflimmern unabhängige Risikofaktoren für die Komplikation eines Perikardergusses nach RFCA bei Tachyarrhythmiepatienten waren. Alter und Größe des linken Vorhofs waren bei Frauen und Patienten mit Vorhofflimmern signifikant höher als bei Männern und Patienten ohne Vorhofflimmern.

Schlussfolgerung

Ein Perikarderguss als Komplikation einer RFCA ist bei Tachyarrhythmiepatienten nicht selten und neigt zur Entwicklung einer Herzbeuteltamponade. Die wirksamste Therapie besteht in der notfallmäßigen Perikardpunktion und -drainage. Weibliches Geschlecht und Vorhofflimmern sind möglicherweise die unabhängigen Risikofaktoren für einen Perikarderguss nach RFCA bei Patienten mit Tachyarrhythmie.

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Acknowledgments

This project was supported by a grant for scientific research from the Chinese Ministry of Education.

Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Internal Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Ave. 1095, 430030, Wuhan, China

    L. Lan, Y. Zeng, W.-R. Wang, N. Chen, Q.-G. Liu, L. Wang, Y. Wang & C.-X. Zhao

  2. Department of Internal Cardiology, Tongji Xianning Hospital, Huazhong University of Science and Technology, Xianning, China

    S.-Y. Gan

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  1. L. Lan
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  2. Y. Zeng
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  3. W.-R. Wang
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  4. N. Chen
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  5. Q.-G. Liu
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  6. S.-Y. Gan
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  7. L. Wang
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  8. Y. Wang
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  9. C.-X. Zhao
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Correspondence to Q.-G. Liu.

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Lan, L., Zeng, Y., Wang, WR. et al. Clinical characteristics and risk factors of pericardial effusion complicating radiofrequency catheter ablation in Chinese Han patients with tachyarrhythmias. Herz 38, 909–914 (2013). https://doi.org/10.1007/s00059-013-3762-x

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  • DOI: https://doi.org/10.1007/s00059-013-3762-x

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