房颤患者术后医源性房间隔缺损发生情况及影响因素分析

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Abstract Objective To investigate the occurrence and influencing factors of postoperative iatrogenic atrial septal defect (ASD) in patients with atrial fibrillation, and to provide evidence for the prevention and treatment of iatrogenic ASD. Methods From December 2014 to December 2017, 118 cases with atrial fibrillation who underwent atrial septal puncture in the First Affiliated Hospital of Dalian Medical University were selected. According to the results of transthoracic echocardiography(TTE) or transesophageal echocardiography(TEE), they were divided into iatrogenic ASD group (n = 18) and normal healing group (n = 83). The clinical data of two groups were compared and the influencing factors of iatrogenic ASD were analyzed. The patients with iatrogenic ASD were followed up for 3 months and the prognosis was observed. Results In iatrogenic ASD group, all patients underwent radiofrequency ablation. Ten cases who underwent left atrial appendage occlusion and 7 cases who underwent frozen balloon ablation were excluded in normal healing group. Patients with iatrogenic ASD were followed up for 3 months, 1 case had lacunar cerebral infarction and 2 cases had migraine. The incidence of persistent atrial fibrillation and international normalized ratio in iatrogenic ASD group was higher than that in normal healing group (P < 0.05), and the left atrial diameter was larger than that in normal healing group (P < 0.05). Logistic regression analyze showed that left atrial diameter＞38 mm was an independent risk factor for iatrogenic ASD (OR = 1.119, 95%CI:1.006-1.245, P = 0.038). Conclusion Iatrogenic ASD is frequent after radiofrequency ablation of atrial fibrillation. The increase of left atrial diameter is an independent risk factor for iatrogenic ASD. Iatrogenic ASD can still lead to clinical events, which should be paid more attention.

Key words： Atrial fibrillation Atrial septal puncture Iatrogenic atrial septal defect Catheter ablation

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	WU Siwen1 ZHANG Rongfeng2 YIN Xiaomeng2 DONG Yingxue2 XIAO Xianjie2 GAO Lianjun2

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WU Siwen1 ZHANG Rongfeng2 YIN Xiaomeng2 DONG Yingxue2 XIAO Xianjie2 GAO Lianjun2. Analysis of the occurrence and influencing factors of postoperative iatrogenic atrial septal defect in patients with atrial fibrillation[J]. 中国医药导报, 2020, 17(11): 44-47.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I11/44

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