论文部分内容阅读
目的在心房颤动(房颤)冷冻球囊消融术中,消融肺静脉经常诱发迷走反射。本研究旨在评估预注射阿托品对此迷走反射的作用。方法连续入选25例接受冷冻球囊消融术的阵发性房颤患者,前12例为试验组,后13例为对照组。试验组在冷冻球囊回缩前静推1 mg阿托品,对照组仅在血流动力学变化[心率和(或)血压降低]开始后给予阿托品,血流动力学变化恢复,即定义为治疗有效。结果试验组中,3例血压一过性降低,无需治疗;1例发生低血压,需要支持治疗。对照组中,分别有6例低血压、3例心动过缓和3例混合性心动过缓-低血压。预注射阿托品可使术中迷走反射发生率显著降低(4/12比12/13,P<0.01)。结论预注射阿托品可预防房颤冷冻球囊消融术中的迷走反射。
Purpose In ablation of atrial fibrillation (atrial fibrillation) in frozen balloon ablation, ablation of pulmonary veins often induces vagal reflexes. This study was designed to evaluate the effect of pre-injected atropine on this vagal reflex. Methods A total of 25 patients with paroxysmal atrial fibrillation who underwent cryosurgery were included in the study. The first 12 patients were in the test group and the last 13 were the control group. The experimental group was given atropine 1 mg atropine bolus prior to the retraction of the frozen balloon and the control group was given atropine only after the onset of hemodynamic changes [heart rate and / or hypotension], hemodynamic changes were defined as being therapeutically effective . Results In the experimental group, 3 patients had a transient decrease in blood pressure without treatment; 1 patient developed hypotension requiring supportive care. In the control group, there were 6 cases of hypotension, 3 cases of bradycardia and 3 cases of mixed bradycardia - hypotension. Pretreatment with atropine significantly reduced the incidence of intraoperative vagal reflex (4/12 vs 12/13, P <0.01). Conclusion Pre-injection of atropine prevents vagal reflex during atrial fibrillation with frozen balloon ablation.