Clinical Characteristics And Risk Factors Of Pericardial Effusion Underwent Radiofrequency Catheter Ablation In Patients With Tachyarrhythmia

Objective:To Summarize the clinical features and analyze the related risk factors of pericardial effusion in tachyarrhythmia patients who underwent radiofrequency catheter ablation.Methods:A total of1756tachyarrhythmia patients, aged6～82(42.29±15.22) years, who underwent radiofrequency catheter ablation from January2006to December2011in our hospital were selected, including894cases of male,862cases of female. And then summarize and analyze their clinical characteristics of the patients that developed pericardial effusion.Results:There are27cases(1.54%) developed pericardial effusion during or after RFCA determined by Echocardiogram, among whom5cases developed cardiac tamponade with decline of blood pressure, raise of heart rate, breathing with difficulty, sweating, irritability and other performance during operation. When the acute cardiac tamponade was determined by Echocardiogram, symptom of4cases was relieved after emergency pericardiocentesis, while one case was discharge after emergency surgical repair. The other22cases suffered from chest pain, bosom frowsty, breathing with difficulty and other symptoms within a few hours, and a small pericardial effusion revealed by Echocardiogram.17patients recovered after aggressive fluid replacement and other conservative treatment, while other5patients get worse after conservative therapy and discharged after pericardiocentesis and drainage. Univariate analysis showed that catheter ablation in patients with atrial fibrillation complicated with pericardial effusion was significantly higher than other arrhythmias. The proportion of atrial fibrillation(11.83%vs.0.96%, P<0.001), female (77.8%vs.48.6%, P<0.01), age (52.63±15.59y vs.42.11±15.15y, P<0.05), left atrial size (33.00±6.58mm vs.30.24±4.75mm, P<0.05) and the days of hospitalization (16.30±12.64d vs.6.41±3.74d, P<0.001), the proportion of patients with diabetes(7.41%vs.0.52%, P<0.01), hypertension(29.6%vs.3.93%, P<0.01), and coronary heart disease(7.41%vs.0.87%, P<0.01) of the pericardial effusion group were significantly increased compared with non-pericardial effusion group. Logistic regression analysis showed that, female[β=1.941, Exp(B)=6.964,95%CI:2.113～22.956, P=0.001], atrial fibrillation[β=3.109, Exp(B)=22.391,95%CI:3.653～137.253, P=0.001]were independent risk factors for the tachyarrhythmia patients who underwent radiofrequency catheter ablation complicated pericardial effusion.Conclusion:Tachyarrhythmia underwent radiofrequency catheter ablation complicated with pericardial effusion is not uncommon, and was prone to develop cardiac tamponade, emergency percardiocentesis and drainage are effective measures to relive symptoms. Women and patients with atrial fibrillation who underwent catheter ablation may be the independent risk factors for pericardial effusion, the former may be related to women are older and with larger left atrium and thinner atrial wall and relatively sensitive than men. Case of pericardial effusion, length of stay was significantly longer.