接受肺静脉隔离消融术的镇静患者术中不稳定的风险因素。

IF 1.2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
International heart journal Pub Date : 2024-11-30 Epub Date: 2024-11-14 DOI:10.1536/ihj.24-152
Masaaki Hayashi, Takeshi Soeki, Yasuhiro Noda, Daiki Tamagami, Keisuke Morinishi, Yusuke Chikata, Tomoko Takahashi, Tomomi Matsuura, Takayuki Ise, Koji Yamaguchi, Shusuke Yagi, Hirotsugu Yamada, Tetsuzo Wakatsuki, Masataka Sata
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引用次数: 0

摘要

持续性或阵发性心房颤动通常在使用异丙酚深度镇静的情况下进行肺静脉隔离(PVI)消融术治疗。术中血流动力学或呼吸不稳定往往会干扰手术过程。我们对本院首次接受心房颤动 PVI 消融术的 80 名患者的风险因素进行了回顾性调查。我们从他们的电子病历和住院期间填写的调查问卷中收集了背景资料和超声心动图检查结果。术中丙泊酚总剂量和栓剂注射(总数和注射量)被定义为患者不稳定的替代指标。以每项指标为因变量,进行单次回归和逐步多元回归。当使用异丙酚总剂量作为因变量时,观察到其与饮酒状态(P < 0.05)和体重指数(BMI)(P < 0.05)有显著关联。如果将静脉注射异丙酚的总次数或容量分别作为因变量,则会发现它们与年龄(P < 0.05)和体重指数(BMI)(P < 0.05)有显著相关性。另外,以丙泊酚总剂量或栓剂注射总数为因变量,以超声心动图参数为自变量进行了统计分析。结果发现,总剂量与左心房尺寸之间存在明显关联(P < 0.05)。这些结果表明,年龄较小、体重指数(BMI)较高(肥胖)以及目前的饮酒状态会对深度镇静下患者的稳定性产生不利影响。为确保消融安全,医生在为 PVI 使用深度镇静时应注意这些风险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk Factors for Intraoperative Instability in Sedated Patients Undergoing Pulmonary Vein Isolation Ablation.

Persistent or paroxysmal atrial fibrillation is typically treated with pulmonary vein isolation (PVI) ablation under deep sedation with propofol. Intraoperative hemodynamic or respiratory instability often interferes with the surgical procedure. We retrospectively investigated risk factors in 80 patients who underwent their first PVI ablation for atrial fibrillation at our hospital. Background and echocardiography findings were collected from their electronic charts and the questionnaires they completed during hospitalization. Total intraoperative propofol dose and bolus injections (total number and volume) were defined as surrogate measures of patient instability. Single and stepwise multiple regression were performed using each measure as the dependent variable. When total propofol dose was employed as the dependent variable, significant associations were observed with drinking status (P < 0.05) and body mass index (BMI) (P < 0.05). When total number or volume of intravenous propofol boluses were each used as the dependent variable, significant associations were noted with age (P < 0.05) and BMI (P < 0.05). Separately, statistical analyses were conducted using total propofol dose or total number of bolus injections as the dependent variable and echocardiography parameters as independent variables. A significant association was detected between total dose and left atrial dimension (P < 0.05). These results suggested that younger age, higher BMI (obesity), and current drinking status adversely affect patient stability under deep sedation. To ensure safe ablation, physicians should pay attention to these risk factors when administering deep sedation for PVI.

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来源期刊
International heart journal
International heart journal 医学-心血管系统
CiteScore
2.50
自引率
6.70%
发文量
148
审稿时长
6-12 weeks
期刊介绍: Authors of research articles should disclose at the time of submission any financial arrangement they may have with a company whose product figures prominently in the submitted manuscript or with a company making a competing product. Such information will be held in confidence while the paper is under review and will not influence the editorial decision, but if the article is accepted for publication, the editors will usually discuss with the authors the manner in which such information is to be communicated to the reader.
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