Severe hypoxemia after radiofrequency ablation for atrial fibrillation in palliatively repaired tetralogy of Fallot: A case report

BACKGROUND Patients with tetralogy of Fallot(TOF)often have arrhythmias,commonly being atrial fibrillation(AF).Radiofrequency ablation is an effective treatment for AF and does not usually cause severe postoperative hypoxemia,but the risk of complications may increase in patients with conditions such as TOF.CASE SUMMARY We report a young male patient with a history of TOF repair who developed severe hypoxemia after radiofrequency ablation for AF and was ultimately confirmed to have a new right-to-left shunt.The patient subsequently underwent atrial septal occlusion and eventually recovered.CONCLUSION Radiofrequency ablation may cause iatrogenic atrial septal injury;thus possible complications should be predicted in order to ensure successful treatment and patient safety.

Segmental radiofrequency ablation of pulmonary vein ostia for patients with refractory paroxysmal atrial fibrillation using multi-slice spiral computed tomography guidance

Objective: To evaluate the safety and clinical efficacy of segmental radiofrequency ablation of pulmonary vein (PV)ostia for patients with refractory paroxysmal atrial fibrillation (AF) under multi-slice spiral computed tomography (MSCT)guidance before the procedure. Methods: A series of 58 consecutive patients with refractory paroxysmal AF were enrolled to undergo segmental radiofrequency ablation ofPV ostia. The 36 male and 22 female patients with mean age of (57.4±9.5) (32～79)atrium (LA) and proximal PVs. Patients then underwent segmental radiofrequency ablation of PV ostia using PV circular mapping catheter manipulated several times to ensure complete isolation between PVs and LA. Results: No complications occurred during the procedure. One patient developed delayed cardiac tamponade, which was drained percutaneously. The mean follow-up time was (17.1±9.3) months. Forty-one patients (95%) experienced improved quality of life one month after the procedure. Thirty-six patients (83%) showed stable sinus rhythm, while 10 patients (23%) required additional anti-arrhythmic drugs. AF returned≥1time in 6 (14%) patients who underwent anti-arrhythmic drug therapy, but the number of episodes was less than that before the procedure. However, one patient experienced recurrent episodes of atrial flutter. Conclusion: It is safe and effective to perform segmental radiofrequency ablation of PV ostia for patients with refractory paroxysmal AF using MSCT guidance mappening.

Hemoptysis secondary to pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation: A case report and literature review

Objectives: Pulmonary vein stenosis(PVS) is a known complication after radiofrequency ablation of atrial fibrillation(RAAF) and is often misdiagnosed owing to lack of awareness regarding PVS among noncardiologists.Misdiagnosis results in unnecessary treatment;therefore, greater understanding of PVS can improve the management of these patients.Methods: We report the case of a 38-year-old man with a history of RAAF who presented with massive hemoptysis.His symptoms persisted despite undergoing transcatheter bronchial artery embolization on two occasions.Results: Pulmonary computed tomography angiography revealed a completely occluded left superior pulmonary vein. Considering the patient’s history of RAAF, we diagnosed him with RAAF-induced PVS and performed left superior lobectomy after which hemoptysis did not recur.Conclusions: Unexplained massive hemoptysis should alert clinicians regarding the possibility of RAAF-induced PVS. Balloon angioplasty and stent placement are used to treat PVS;however, their efficacy is controversial considering the high recurrence rates associated with these interventions.

Endoscopic management of an esophagopericardial fistula after radiofrequency ablation for atrial fibrillation

A case is reported of a 76-year-old man with a past history of atrial fibrillation. A radiofrequency ablation procedure was suggested following several failed cardioversion attempts. However, an esophagopericardial fistula complicated the procedure. This life-threatening complication was successfully managed using both the placement of a covered esophageal stent and surgical pericardial and mediastinal drainage. In fact, no persisting fistula could be detected when the esophageal stent was removed seven weeks later. Atrioesophageal and esophagopericardial fistulas are two of the most severe complications associated with cardiological radiofrequency ablation procedures. They are responsible for majority of the deaths associated with this procedure. Despite the extremely high morbimortality associated with cardiothoracic surgery in such conditions, this treatment is the gold-standard for the management of such complications. This case report emphasizes the importance and efficacy of the endoscopic approach as part of a multidisciplinary management approach to this serious adverse event following radiofrequency ablation for atrial fibrillation.

Successful Anesthetic Management for Surgical Repair of Atrio-Esophageal Fistula Following Radiofrequency Ablation for Atrial Fibrillation

Introduction: Atrio-esophageal fistula is a rare but often fatal complication of radiofrequency ablation for atrial fibrillation. Here we report a successful case in anesthetic management of surgical repair of atrio-esophageal fistula. Case Report: The patient was a 56-year-old man status post radiofrequency ablation for atrial fibrillation one month before presenting with fever and symptoms and signs of cerebral emboli. He was diagnosed as having atrio-esophageal fistula, which required emergent surgical repair. In the operating room, rapid sequence induction was performed with avoidance of positive pressure ventilation before securing airway. Double lumen tube was used for lung isolation for left thoracotomy. Upon exploration, a small fistula was identified. Both atrial and esophageal defects were ligated and an intercostal muscle flap was placed. The patient’s heart rhythm was atrial flutter/atrial fibrillation with marginal hemodynamics during the procedure, but cardioversion was delayed until the fistula was repaired and no remaining air, blood clot or gastric content in the heart was confirmed by epicardial ultrasound. The patient tolerated the surgery and was transferred to ICU, intubated and ventilated. He recovered from surgery and was transferred to a rehabilitation hospital with residual expressive aphasia. Conclusion: We had a successful case in anesthetic management for surgical repair of atrio-esophageal fistula by preventing massive bleeding as well as multiple air embolization through the fistula.

Design and Baseline Patient Characteristics of the Prospective, Observational, Multicenter and Multinational Cohort Study Comparing Radiofrequency with Cryoablation for Pulmonary Vein Isolation in Patients with Atrial Fibrillation—The Freeze Cohort Study

Aims: The FREEZE-cohort study (NCT 01360008) is a prospective observational, multicenter and multinational study to evaluate safety and effectiveness of cryoballoon ablation for pulmonary vein isolation as compared to radiofrequency ablation in patients with paroxysmal or persistent atrial fibrillation (lasting < one year) under the conditions of clinical routine. Methods and Results: The study started in 2011 and anticipates inclusion up to 2000 patients in each of the two treatment groups. A total of 37 centers from 8 countries worldwide, all experienced in at least one of the two ablation techniques, participate in the study. The primary outcome parameter of the study is defined as atrial fibrillation recurrence rate during twelve months of follow-up. Secondary outcome parameters include primary success rates, complication rates in general, specific complications with respect to phrenic nerve palsy and pulmonary vein stenosis, radiation exposure, clinical course including death and repeat ablation. Finally specific procedural aspects will be evaluated in a descriptive manner. Preliminary data of the first 1882 patients show that in clinical practice cryoablation is preferentially performed in patients with paroxysmal atrial fibrillation, whereas application of radiofrequency ablation is equally distributed between patients with persistent and paroxysmal atrial fibrillation. Conclusion: Based on multi-center and multi-national data the FREEZE-cohort study will provide important information on long-term efficacy, clinical effectiveness, complication rates and procedural differences between atrial fibrillation patients treated with either cryoablation or radiofrequency ablation.

Catheter ablation of persistent atrial fibrillation:The importance of substrate modification

Accumulating data have shown that elimination of atrial fibrillation(AF) sources should be the goal in persistent AF ablation. Pulmonary vein isolation, linear lesions and complex fractionated atrial electrograms(CFAEs) ablation have shown limited efficacy in patients with persistent AF. A combined approach using voltage, CFAEs and dominant frequency(DF) mapping may be helpful for the identification of AF sources and subsequent focal substrate modification. The fibrillatory activity is maintained by intramural reentry centered on fibrotic patches. Voltage mapping may assist in the identification of fibrotic areas. Stable rotors display the higher DF and possibly drive AF. Furthermore, the single rotor is usually consistent with organized AF electrograms without fractionation. It is therefore quite possible that rotors are located at relatively "healthy islands" within the patchy fibrosis. This is supported by the fact that high DF sites have been negatively correlated to the amount of fibrosis. CFAEs are located in areas adjacent to high DF. In conclusion, patchy fibrotic areas displaying the maximum DF along with high organization index and the lower fractionation index are potential targets of ablation. Prospective studies are required to validate the efficacy of substrate modification in left atrial ablation outcomes.

The correlation between MFAP4 and recurrence and clinical outcome of atrial fibrillation after radiofrequency catheter ablation

Objective:To investigate the correlation between Microfibrillar-associated protein 4(MFAP4)and recurrence and clinical outcome of atrial fibrillation(AF)after radiofrequency catheter ablation(RFCA).Methods:A total of 101 patients with AF admitted to our department from December 2018 to January 2020 were treated with RFCA.The average follow-up period was(11.91±0.38)months.They were divided into recurrence group and non-recurrence group according to whether they had recurrence of AF.The levels of MFAP4,transforming growth factor-β1(TGF-β1),cardiac ultrasound indexes,body mass index(BMI)and major cardio-cerebral vascular events were compared between the two groups.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of MFAP4 for recurrence of AF after RFCA.Results:The levels of MFAP4,TGF-β1,left atrial diameter(LAD)and BMI in the recurrent group were higher than those in the non-recurrent group(P<0.05).The left ventricular ejection fraction(LVEF)in the recurrent group was lower than that in the non-recurrent group(P<0.05).The levels of MFAP4,TGF-β1 and LAD in the patients of recurrent paroxysmal AF and persistent AF after RFCA were higher than those in the respective non-recurrent patients(P<0.05).MFAP4 was positively correlated with TGF-β1 and LAD(P<0.05).Logistic regression analysis showed that MFAP4,TGF-β1,and LAD were independent risk factors for recurrence of AF after RFCA.The ROC curve analysis showed that the area under the ROC curve of MFAP4 for predicting recurrence of AF after RFCA was 0.888(P=0.000),and the optimal cut-off value was 19.295ng/ml,with a sensitivity of 77.3%and a specificity of 77.2%.The incidence of readmission and total adverse events in recurrence group was significantly higher than that in non-recurrence group(P<0.05).Conclusions:MFAP4 was significantly increased in patients with recurrence after RFCA of AF,which was one of the independent risk factors for recurrence after RFCA of AF,and had certain clinical application value.

RADIOFREQUENCY CATHETER ABLATION OF PERMANENT ATRIAL FIBRILLATION UNDER GUIDANCE OF CARTO-MERGE TECHNIQUE

Objective To investigate the feasibility and effectiveness of radiofrequency catheter ablation (RFCA) to treat permanent atrial fibrillation (AF) under the guidance of Carto-Merge technique. Methods Fifteen male patients with permanent AF underwent RFCA under the guidance of Carto-Merge technique. The mean age was 54.00±10.44 years, and duration of AF was 23.66±14.93 months. Cardiac magnetic resonance angiography (MRA) was performed to obtain pre-procedural three-dimensional (3D) images on the anatomy of left atrium (LA) and pulmonary veins (PVs) before RFCA procedure. Then the electroanatomical map was integrated with 3D images of MRA to form Carto-Merge map that guided step-by-step ablation strategy of permanent AF. Circumferential PV ablation was performed first until complete PVs electric isolation confirmed by Lasso catheter. If AF was not terminated, lesion lines on roof of LA, mitral isthmus, and tricuspid isthmus were produced. Results The episodes of AF were terminated during RFCA in 2 patients, by direct current cardioversion in the remaining 13 patients. Transient AF occurred in 2 patients after ablation on 1st day and 1st week respectively, AF terminated spontaneously not long after taking metoprolol. One patient developed persistent atrial flutter (AFL) in 2 months after procedure and AFL was eliminated by the second ablation. Persistent AF recurred on 1st day, 1st and 5th week respectively in 3 patients, and did not terminate after 3 months even though amiodarone was given. The remaining 12 patients were all free of AF during 2-11 months of follow-up. The recent success rate for RFCA of permanent AF was 80%. Conclusions Carto-Merge technique can effectively guide RFCA of permanent AF. When combined with single Lasso mapping, it can simplify the mapping, lower expenses, and enhance the success rate of RFCA of permanent AF.

Simple hematological predictors of AF recurrence in patients undergoing atrial fibrillation ablation

Backgound Red cell distribution width(RDW) and neutrophil-to-lymphocyte ratio(NLR) are simple hematologic indices that have been used to predict adverse outcomes in different clinical settings. The aim of our study is to determine whether RDW and NLR can predict atrial fibrillation(AF) recurrence in patients undergoing AF ablation. Methods Consecutive patients, without known hematological disorders, who underwent AF catheter ablation between January 2014 and April 2017 were enrolled into this study. Blood samples were taken one day before and five hours after the ablation procedure. Results A total of 346 patients(224 males(65%), mean age: 59 ± 11 years old) were included. After a mean follow up of 26.2 ± 12.1 months, 80(23.1%) patients experienced late AF recurrence(defined as any recurrence after the blanking period of three months), while 97(28%) patients experienced early AF recurrence during the blanking period. Univariate analysis showed that early arrhythmia recurrence, type of AF and NLR after the procedure were significantly associated with late AF recurrence, while early arrhythmia recurrence and NLR remained significant in multivariate analysis. RDW was not associated with late AF recurrence. None of the parameters above predicted early arrhythmia recurrence. Conclusions Simple and inexpensive hematological indices such as NLR should be evaluated for their ability to predict AF recurrence in patients undergoing catheter ablation in larger prospective studies.

A three-year longitudinal study of the relation between left atrial diameter remodeling and atrial fibrillation ablation outcome

在 post-radiofrequency 导管脱离(RFCA ) 的地位上改变 atrial 纤维性颤动(AF ) 的左 atrial 直径(男孩) 的 BackgroundThe 长期的预示的影响是不清楚的。这研究从 3 年的 echocardiographic 数据雇用了一个二阶段的模特儿比用基线 LAD.MethodsData 的模型来自有经历 RFCA 的药倔强的 AF 的 263 个连续病人是回顾地镇定的的查明二阶段的模型是否更有利地预言 RFCA 结果。男孩的常规 echocardiographic 大小在 RFCA 以后在基线， 1， 3， 6，和 12 个月然后每 6 个月被执行。性别，年龄， AF 的类型， RFCA 的数字，和 AF 地位被记录。我们获得实际(预言) 用一个纵的线性混合模型的 3 年的男孩(1 st 舞台) 。逻辑回归基于基线男孩(模型 1 ) 当模特儿，实际(预言)3 年的男孩(模型 2 )(2 nd 舞台) ，并且观察 3 年的男孩(模型 3 ) 被构造预言 RFCA 结果。在操作典型曲线(AUC ) 的接收装置下面的区域被用来估计弄平的曲线显示了的 models.ResultsThe lowess 的表演 LAD 在开始的三个月拒绝了并且在 RFCA 以后仍然保持稳定直到 36 个月。男孩减小的度被基线男孩显著地影响。非发作性的 AF，大男孩和女性是 AF 复发的重要预言者。模型 2 在纵的基于学习的二阶段的模型超过的三 models.ConclusionsThis 之中有最大的 AUC 用基线男孩的原来的逻辑模型。非发作性的 AF，更大的男孩和女性是 RFCA 失败的重要预言者。

Rotor identification by body surface mapping and endocardial mapping：impact on atrial fibrillation ablation

为及时反映海外心脏病学领域的最新进展，努力缩短国内外心电学研究的差距，自本期起，本刊推出“海外论坛”栏目。本栏目主要刊发国内外心脏病学研究领域前沿成果的专题述评、综述和重要学术会议快报等，形式不拘。欢迎海内外学者惠赐大作!

Single dose of ibutilide for conversion of persistent atrial fibrillation after radiofrequency ablation

Background Patients with persistent or permanent atrial fibrillation （AF） often need direct current cardioversion after radiofrequency ablation. The aim of this study was to investigate the effectiveness and safety of ibutilide for cardioversion of persistent or permanent atrial fibrillation after radiofrequency ablation and the factors related to conversion. Methods Patients with persistent or permanent atrial fibrillation were treated with combined ablation strategy including circumferential pulmonary vein isolation, linear ablation and CAFE potential ablation. If AF was not terminated after ablation, ibutilide was used for cardioversion （1 mg, intravenous injection in 10 minutes）. These patients were divided into a conversion group and a non-conversion group according to whether AF was converted to sinus rhythm within 30 minutes after administration. ECG monitoring was performed during the injection of ibutilide. Atrial waves recorded by coronary sinus electrodes were measured for calculating average wavelength of AF waves in six seconds. The QT interval was measured immediately after conversion and 2 hours after injection of ibutilide.Results Forty patients whose AF was not converted to sinus rhythm after radiofrequency ablation were given an intravenous injection of ibutilide. Of the 40 patients, 29 cases were converted to sinus rhythm, with a conversion rate of 72.5%. The average conversion time was （13.2±5.5） minutes. Compared with the conversion group, patients in the non-conversion group had a longer history of AF （9.4±5.3） years vs. （4.3±2.8） years, P 〈0.05）, and a markedly enlarged left atrium （47.3±2.9） mm vs. （42.1±4.5） mm, P〈0.05）. There were no significant differences in gender, age, body mass index and left ventricular function between the two groups. Ibutilide significantly prolonged the average wavelength of the AF wave （171.8±29.5） ms vs. （242.0±40.0） ms, P 〈0.001）. Two hours after ibutilide treatment, the QT interval was significantly shortened （421.0±24.7） ms vs. （441.0±37.4） ms, P〈0.05）. No cases of serious arrhythmias or other adverse reactions were found.Conclusions A single dose of ibutilide for conversion of persistent or permanent AF after radiofrequency ablation is safe and effective.

Tale of fat and fib-cardiac lipoma managed with radiofrequency ablation: A case report

BACKGROUND Cardiac lipoma and lipomatous hypertrophy of interatrial septum(LHIS)are very rare disorders with distinct pathological features.While cardiac lipoma is a well-circumscribed encapsulated tumor of mature adipocytes,LHIS is due to entrapment of fat cells in the interatrial septum during embryogenesis.Although a biopsy is the definitive diagnostic test,these disorders can be differentiated by a cardiac magnetic resonance imaging(MRI).Treatment of LHIS is not warranted in asymptomatic patients.In symptomatic patients,surgical resection is the only recommended treatment,which has shown to improve good long-term prognosis.CASE SUMMARY A 63-year-old Caucasian woman with past medical history significant for hypertension,hypothyroidism,right breast ductal cell carcinoma treated with mastectomy and breast implant,platelet granule disorder,asthma requiring chronic intermittent prednisone use,presented to the outpatient cardiology office with recent onset exertional dyspnea,palpitations,weight gain and weakness.Initial workup with electrocardiogram and holter monitor did not reveal significant findings.During the subsequent hospitalization for community acquired pneumonia,the patient developed symptomatic paroxysmal atrial fibrillation.Transthoracic echocardiogram showed a right ventricular mass.A biopsy was not pursued given the high risk of bleeding due to platelet granule disorder.Cardiac MRI showed characteristic features consistent with cardiac lipoma and LHIS.Prednisone was discontinued.Genetic testing for arrhythmogenic right ventricular dysplasia and 24-h urine cortisol test was negative.As multiple attempts at rhythm control failed with sotalol and flecainide,pulmonary vein isolation and right atrial isthmus radiofrequency ablation were done.She is in follow-up with symptomatic relief and no recurrence of atrial fibrillation for 10 mo.CONCLUSION Benign fatty lesions in heart include solitary lipoma,lipomatous infiltration and lipomatous hypertrophy of interatrial septum.Although transvenous biopsy provides a definitive diagnosis,Cardiac MRI is superior to computed tomography and aids in differentiating benign from malignant lesions.Surgical excision of cardiac lipoma along with capsule and pedicle removal generally prevents recurrence,but with our patient’s unusual tumor features and comorbidities proscribed a surgical approach.Symptom management with antiarrhythmics and ablation techniques were successfully utilized.

Severe esophageal injury after radiofrequency ablation-a deadly complication

Various degrees of esophageal injury have been described after radiofrequency ablation performed for treatment of atrial fibrillation. The main mechanism of injury is thermal and may lead to a range of esophageal mucosal changes, some clinically insignificant, however when deep ulceration occurs, this may be further complicated by perforation and mediastinitis, a rare but life threatening sequelae. We present a case of a severe esophageal injury leading to mediastinitis, with interesting endoscopic findings.

A three-pulmonary vein isolation approach to treat paroxysmal atrial fibrillation

Objective To investigate the safety and efficacy of a 3-pulmonary vein (PV) isolation approach in treating paroxysmal atrial fibrillation (AF). Methods Radiofrequency catheter ablation was used to eliminate PV potential in 11 patterns with frequent paroxysmal AF refractory to anti-arrhythmic agents. During sinus rhythm, PV potential was mapped in the left and right superior PVs and left inferior PV. The procedural success was defined as the elimination of PV potential in the 3 PVs. Restults PV potential was identified and abolished in a total of 24 PVs, mostly in the left and right superior PV. There was no pulmonary stenosis or other complications during or after the procedures. AF recurred in one patient after an average of 12 ± 3 month follow-up. Conclusions PV potemials were present mostly in the left or right superior PV. The 3-PVs isolation approach is safe and effective in preventing drug-resistant paroxysmal AF.

心房颤动患者射频消融术后居家运动康复强度-时间依从性轨迹及预测因素的纵向研究

背景我国心房颤动(以下简称房颤)患病率逐年升高,患者的预后及生活质量亟需关注。现有研究证实运动康复是改善房颤射频消融术后患者预后及生活质量不佳的有效方式。依从性是衡量运动康复益处是否持续存在的关键指标,但其变化轨迹未知。目的基于前瞻性纵向观察的心房颤动患者射频消融术后居家运动康复强度-时间依从性5期追踪数据,考察发展轨迹及预测因素。方法采用便利抽样法,选取2020年5—11月就诊于南京医科大学第一附属医院心血管内科行射频消融术的246例房颤患者为研究对象进行随访。其中入组1周为基线调查,入组后3、6、9个月和12个月为追踪调查。收集患者的一般资料;本研究使用智能设备或运动日志对依从性进行监督和记录,从强度-时间依从性评估运动依从性;采用运动自我效能量表(SEE)、运动恐惧量表(Fact-CHF)、领悟社会支持量表(PSSS)、患者积极度量表(PAM13)分别评估患者的运动自我效能、运动恐惧水平、社会支持情况、积极度水平。利用Mplus工具构建潜类别增长模型(LCGM),取最优的拟合模型确定房颤患者射频消融术后居家运动康复强度-时间依从性的发展轨迹,采用Logistic回归分析识别轨迹类别的预测因素。结果44例患者失访,最终共202例纳入分析。基线、运动3个月、运动6个月、运动9个月、运动12个月患者例数分别为202、201、185、174例和159例,患者强度-时间依从性分别为(0.83±0.55)、(1.07±0.54)、(0.99±0.57)、(0.91±0.55)、(0.89±0.60)。LCGM结果显示,患者的运动康复强度-时间依从性变化过程具有群体异质性,分为3个潜类别轨迹组:缓慢下降-低水平组(n=69,34.2%)、快速上升-高水平组(n=14,6.9%)、持续依从组(n=119,58.9%)。无序多分类Logistic回归分析结果显示,以缓慢下降-低水平组为参照组,快速上升-高水平组和持续依从组男性患者的强度-时间依从性水平更高(P<0.001);快速上升-高水平组和持续依从组患者的年龄更大,运动自我效能水平更高(P<0.05);快速上升-高水平组患者的运动恐惧水平更低(P<0.05);持续依从组患者的积极度水平更高(P<0.05)。结论房颤患者射频消融术后居家运动康复强度-时间依从性呈多类别曲线增长的发展轨迹;未来可依据依从性的时变特点和因素定期进行强化干预,进而提高患者居家运动康复依从性水平且保持稳定。

不间断抗凝治疗患者心房颤动射频消融术后体位及制动时间的探讨

目的:探讨在不间断抗凝治疗的心房颤动患者行射频消融术后不同绝对平卧时间的应用效果。方法:将2022年6月至2022年9月收治的300例行心房颤动射频消融术治疗并且不间断抗凝治疗的患者根据术后绝对平卧时间进行分组,其中对照组实施绝对平卧8h,观察组实施绝对平卧2h,分别对两组患者的腰背疼痛情况、血管并发症、尿潴留情况、术肢麻木、舒适度、24h睡眠时间和患者满意度进行比较分析。结果:与对照组相比,观察组患者的术后4~8h的腰背疼痛评分和术肢麻木情况均更低(P<0.05),且舒适度评分、满意度评分和24h睡眠时间更高(P<0.001),血管并发症无增加。结论:不间断抗凝治疗患者心房颤动射频消融术后实施绝对平卧2h,可有效减轻其腰背疼痛程度和术肢麻木的发生,提升患者睡眠时间和卧床期舒适度和患者满意度,并不增加出血、血肿等血管并发症,临床应用效果显著。