TAVR术后心律失常的发生情况及危险因素分析

Occurrence and Risk Factors of Arrhythmia After Transcatheter Aortic Valve Replacement

目的 探讨经导管主动脉瓣置换术(TAVR)术后心律失常的发生情况及危险因素。方法 选取医院2021年12月至2022年12月收治的经TAVR术治疗的149例主动脉瓣狭窄(AS)患者,收集患者的基本资料,根据患者TAVR术后是否发生心律失常分组,观察患者心律失常发生情况并采用logistic回归分析影响因素。结果 149例患者中31例发生心律失常,发生率为20.81%。心律失常组与非心律失常组体重指数、病程、左室射血分数(LVEF)、三尖瓣关闭不全、主动脉阻断时间差异有统计学意义(P<0.05);将影响因素纳入多因素logistic回归分析,采用逐步前进法,结果显示,体重指数(OR=3.554,95%CI:1.167~10.819)、病程(OR=3.080,95%CI:1.336~7.099)、LVEF(OR=3.242,95%CI:3.114~24.821)、三尖瓣关闭不全(OR=1.394,95%CI:1.135~1.712)、主动脉阻断时间(OR=1.910,95%CI:1.127~3.236)均为影响TAVR术心律失常的危险因素(P<0.05)。结论 TAVR术后心律失常发生率为20.81%。体重指数、病程、LVEF、三尖瓣关闭不全、主动脉阻断时间均为心律失常发生危险因素,应加强心律失常影响因素的重点预防,结合有效措施降低心律失常发生率。

Objective To investigate the incidence and risk factors of arrhythmia after transcatheter aortic valve replacement(TAVR).Methods A total of 149 patients with aortic stenosis(AS)treated by TAVR in hospital from December 2021 to December 2022 were selected.Basic data of the patients were collected,patients were grouped according to whether they had arrhythmia after TAVR,the occurrence of arrhythmia in the patients was observed,and the influencing factors were analyzed by logistic regression.Results Arrhythmia occurred in 31 of 149 patients(20.81%).There were significant differences in body mass index,disease course,left ventricular ejection fraction(LVEF),tricuspid valve insufficiency and aortic occlusion time between arrhythmia group and non-arrhythmia group(P<0.05).The influencing factors were included in multivariate logistic regression analysis,and the progressive method was adopted.The results showed that body mass index(OR=3.554,95%CI:1.167-10.819),disease duration(OR=3.080,95%CI:1.336-7.099),LVEF(OR=3.242,95%CI:3.114-24.821),tricuspid valve insufficiency(OR=1.394,95%CI:1.135-1.712)and aortic occlusion time(OR=1.910,95%CI:1.127-3.236)were all risk factors for arrhythmia during TAVR surgery(P<0.05).Conclusion The incidence of arrhythmia after TAVR was 20.81%.Body mass index,course of disease,LVEF,tricuspid valve insufficiency and aortic occlusion time are all risk factors for arrhythmias.Prevention of these factors should be emphasized and effective measures should be taken to reduce the incidence of arrhythmias.