心房颤动患者射频消融术中清醒状态下电复律疗效观察  

Efficacy of awake electrical cardioversion during radiofrequency ablation of atrial fibrillation

作　　者：边文慧 李杰[2] 代学帅 王雅民 马振泉 BIAN Wenhui;LI Jie;DAI Xueshuai;WANG Yamin;MA Zhenquan(The First Clinical Medical College of Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Weifang Hospital of Traditional Chinese Medicine,The Second Department of Cardiovascular Disease,Weifang 261041,China)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250355 [2]潍坊市中医院心血管病二科,山东潍坊261041

出　　处：《广州医药》2025年第2期166-170,共5页Guangzhou Medical Journal

摘　　要：目的探讨术中未恢复窦性心律需要行电复律的心房颤动(房颤)患者在清醒和镇静两种状态下的安全性及有效性。方法选择2022年1月—2023年12月100例接受射频消融术中行同步直流电复律的持续性房颤患者进行研究,采用随机数字表法将患者分为观察组(清醒状态)和对照组(镇静状态),其中观察组和对照组各为50例。观察两组患者接受电复律的成功率、复发率和不良事件发生率(呼吸抑制、低血压、谵妄、肺水肿、心律失常)等指标。结果观察组和对照组首次电复律成功分别有48、49例,成功率分别为96%、98%,组间比较差异无统计学意义(P=0.558)。观察组术后30 min内有2例复发,对照组术后30 min内无复发,组间比较差异无统计学意义(P=0.153)。在不良反应方面,观察组共发生1例心律失常事件,1例低血压事件,不良反应的总发生率为4%。对照组共发生3例呼吸抑制事件、2例谵妄事件、1例心律失常事件、2例低血压事件,不良反应的总发生率为16%,组间比较差异有统计学意义(P=0.046)。结论对持续性房颤患者在射频消融术中,处于清醒状态下行电复律也具有良好的临床疗效,可以减少不良事件的发生,安全性更高。Objective To compare the safety and efficacy of awake state and sedation state in patients with atrial fibrillation(AF)who did not recover sinus rhythm and needed electrical cardioversion during operation.Methods A total of 100 patients with persistent atrial fibrillation who underwent synchronous direct current cardioversion during radiofrequency ablation from January 2022 to December 2023 were selected and divided into the observation group(awake state)and the control group(sedation state)according to the random number table method,with 50 cases in each group.The success rate of electrical cardioversion,recurrence rate and incidence of adverse events(respiratory depression,hypotension,delirium,pulmonary edema,arrhythmia)were observed.Results The first electrical cardioversion was successful in 48 and 49 patients in the observation group and the control group,and the success rates were 96%and 98%,respectively.There was no significant difference between the two groups(P=0.558).There were 2 cases of recurrence in the observation group and no recurrence in the control group within 30 minutes after operation,and there was no significant difference between the two groups(P=0.153).In terms of adverse reactions,there were 1 case of arrhythmia event and 1 case of hypotension event in the observation group,and the total incidence of adverse reactions was 4%.There were 3 cases of respiratory depression events,2 cases of delirium events,1 case of arrhythmia events,and 2 cases of hypotension events in the control group.The total incidence of adverse reactions was 16%,and the difference between the two groups was statistically significant(P=0.046).Conclusions Electrical cardioversion in awake state during radiofrequency ablation of persistent atrial fibrillation has a good clinical efficacy and safety,which can reduce the occurrence of adverse events.

关 键 词：心房颤动 射频消融术 电复律 清醒状态 镇静状态 

分 类 号：R541.75[医药卫生—心血管疾病]