Iatrogenic aortic dissection during catheter ablation for ventricular arrhythmia.

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Tác giả: Rong Bai, Ke Chen, Shuiyin Ding, Jianzeng Dong, Chuanyu Gao, Weili Ge, Liguo Jian, Chenxi Jiang, Yiwei Lai, Songnan Li, Erpeng Liang, Deyong Long, Changsheng Ma, Jifang Ma, Jungang Nie, Caihua Sang, Weifeng Song, Ribo Tang, Xianqing Wang, Ronghui Yu, Xiaobiao Zang

Ngôn ngữ: eng

Ký hiệu phân loại:

Thông tin xuất bản: United States : Heart rhythm , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 722895

 BACKGROUND: Attempted catheter manipulation through the retrograde aortic approach carries a risk of aortic dissection (AD) during catheter ablation. OBJECTIVE: This study aimed to determine the incidence, management, and outcomes of iatrogenic AD associated with ablation of ventricular arrhythmia (VA). METHODS: All patients who sustained iatrogenic AD during retrograde aortic VA ablation at 6 centers between January 1, 2011, and September 30, 2023, were prospectively identified. RESULTS: Of 5925 patients who underwent ablation procedures during the study period, iatrogenic AD developed in 18 (0.3%
  8 type A AD, 10 type B AD) during the procedure. The mean age was 65.4 ± 5.3 years, and 5 patients (27.8%) were female. Considerable catheter resistance was reported in all cases. Presenting symptoms included sudden-onset severe chest pain (n = 13 [72.2%]), back pain (n = 9 [50%]), abdominal pain (n = 3 [16.7%]), and syncope (n = 3 [16.7%]). Of the type A AD patients, 3 (37.5%) with antegrade dissection underwent surgical repair, and 2 (25%) with retrograde dissection were successfully managed conservatively. Three (30%) of the type B AD patients underwent endovascular intervention and 7 (70%) were managed medically. Three patients (16.7%) died
  all had type A AD and died of severe hemodynamic compromise. None of the 15 survivors had aorta-related complications during a mean follow-up of 72.7 ± 46.8 months. CONCLUSION: Iatrogenic AD is a rare but potentially lethal complication of retrograde aortic VA ablation. Comprehensive measures should be taken to reduce the risk of iatrogenic AD.
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