【摘要】 目的:认识心房颤动(房颤)导管消融术的另一种并发症——急性心力衰竭(心衰)。方法:回顾分析12例既往无心力衰竭史、因房颤经导管消融术后早期发生急性心衰患者的临床资料。结果:1032例房颤导管消融术后48h内发生急性心衰12例(1.2%),12例中慢性房颤11例,阵发性房颤1例。临床表现为呼吸急促12例(100%),其中端坐呼吸8例(67%),剧烈胸痛2例(17%),发热(37.5℃～38.5℃)6例(50%),肺部湿性啰音12例(100%),心室率增快12例(100%),低血压1例(8%),胸片提示胸腔积液3例(25%)、肺水肿改变4例(33%),经胸超声心动图提示少量心包积液5例(42%),白细胞计数大于10.0×109/L7例(58%),左室射血分数(59.6±3.2)%。所有患者于治疗后2～7d内临床症状消失。结论:房颤导管消融术后早期可能会发生心衰,合理的支持治疗可在短期内改善病情。更多还原

【Abstract】 Objective:To describe a new complication after catheter ablation for atrial fibrillation(Af).Method:Retrospectively analyze the clinical data of early heart failure after catheter ablation for Af from January in 2006 to December in 2007. Result:The 12(1.2%) of 1032 patients( 9 males,mean age [66±7] years ),composed of 1 paroxysmal Af and 11 chronic Af,were enrolled due to heart failure during 48h after catheter ablation for Af. The common symptoms were as follows:dyspnea in 12 (100%),orthopnea in 8(67%),intense thoracalgia in 2(17%),fever in 6(50%),pulmonary rales in 12(100%),inceasing heart rate in 12(100%),hypotension in 1(8%),pleural effusion in 3(25%),pulmonary edema signs on sternum in 4(33%),mild pericardial effusion in 5(42%),white blood cell count more than 10.0×109/L in 7 (58%)and left ventricular ejection fraction (59.6±3.2)% in all patients. Clinical symptoms resolved by 2-7 d rational treatment. Conclusion:Patients undergoing catheter ablation for Af are at risk for heart failure during early phase after intervention. With supportive therapy,this complication appears to be well-manageable within a short-term.更多还原