摘要
目的 比较肥厚型梗阻性心肌病(HOCM)患者室间隔乙醇消融术(ASA)与室间隔心肌切除术(SSM)后中期心电图(ECG)变化特点。方法 回顾性分析2010年1月1日至2020年12月31日在上海长海医院确诊的92例HOCM患者临床资料,其中接受ASA术43例,接受SSM术49例。比较两种术式随访3个月ECG,总结其变化特点。结果 术后3个月,ASA组、SSM组分别有22例(51.16%)、2例(4.08%)患者新发完全性右束支传导阻滞(χ^(2)=26.329,P<0.01),分别有2例(4.65%)、13例(26.53%)新发完全性左束支传导阻滞(χ^(2)=8.034,P=0.005),差异均有统计学意义。SSM组9例(18.37%)新发心房颤动,高于ASA组2例(4.65%)(χ^(2)=4.093,P=0.043)。SSM组左心室肥厚缓解率较高于ASA组(44.90%比25.58%,P=0.054)。结论 ASA术后新发完全性右束支传导阻滞比例显著高于SSM,而SSM术后新发完全性左束支传导阻滞、心房颤动比例显著高于ASA。
Objective To compare the changes of electrocardiogram(ECG) after septal alcohol ablation(ASA) and surgical septal myocardial resection(SSM) in patients with hypertrophic obstructive cardiomyopathy(HOCM). Methods The clinical data of 92 patients with HOCM, whose diagnosis was confirmed at Shanghai Changhai Hospital of China between January 1, 2010 and December 31, 2020, were retrospectively analyzed.Of the 92 patients, 43 received ASA and 49 received SSM. The patients were followed up for 3 months, the two types of surgery were compared and the postoperative ECG changes were analyzed. Results Three months after surgery, newly-developed complete right bundle branch block(CRBBB) occurred in 22 patients(51.16%, 22/43) of ASA group and 2 patients(4.08%, 2/49) of SSM group(χ^(2)=26.329, P=0.000), and newlydeveloped complete left bundle branch block(CLBBB) occurred in 2 patients(4.65%) of ASA group and 13patients(26.53%) of SSM group(χ^(2)=8.034, P=0.005), the differences between the two groups were statistically significant. In SSM group 18.37% of patients(9/49) developed new atrial fibrillation(AF), which was remarkably higher than 4.65% of patients(2/43) in ASA group(χ^(2)=4.093, P=0.043). The remission rates of left ventricular hypertrophy(LVH) in SSM group and ASA group were 44.90% and 25.58% respectively(P=0.054) Conclusion The incidence of postoperative newly-developed CRBBB of ASA therapy is significantly higher than that of SSM therapy, while the incidences of postoperative newly-developed CLBBB and AF of SSM therapy are strikingly higher than those of ASA therapy.(J Intervent Radiol, 2022, 31: 660-663)
作者
赵耀
张芹
曹城玮
程梓萌
蒙绪良
赵腾
张敏
赵海娟
李珂
黄松群
黄新苗
ZHAO Yao;ZHANG Qin;CAO Chengwei;CHENG Zimeng;MENG Xuliang;ZHAO Teng;ZHANG Min;ZHAO Haijuan;LI Ke;HUANG Songqun;HUANG Xinmiao(Department of Cardiology,Affliated Changhai Hospial,Naval Medical University,Shanghai 200433,Chin)
出处
《介入放射学杂志》
CSCD
北大核心
2022年第7期660-663,共4页
Journal of Interventional Radiology
基金
上海市卫生健康委科研面上项目(202140497)。
关键词
肥厚型梗阻性心肌病
室间隔乙醇消融术
室间隔心肌切除术
心电图
束支传导阻滞
hypertrophic obstructive cardiomyopathy
septal alcohol ablation
surgical septal myocardial resection
electrocardiogram
bundle branch block
作者简介
通信作者:黄新苗E-mail:huangxinmiao@hotmail.com。
