心脑血管病防治2025，Vol.25Issue(4)：5-8,40,5.DOI:10.3969/j.issn.1009-816x.2025.04.002
围手术期不同抗凝策略对低危心房颤动导管消融术后急性脑栓塞发生的影响
Impact of different perioperative anticoagulation strategies on the incidence of acute cerebral embolism after catheter ablation in low-risk atrial fibrillation patients
摘要
Abstract
Objective To investigate the impact of different perioperative anticoagulation strategies on the incidence of acute cerebral embolism(ACE)after catheter ablation in low-risk atrial fibrillation(AF)patients(CHA2DS2-VASc score≤1 for males and≤2 for females).Methods A total of 84 low-risk AF patients who underwent their first catheter ablation at Xuzhou Central Hospital from December 2019 to June 2021 were continuously enrolled.They were divided into an anticoagulation group(27 cases)and a control group(57 cases)based on whether they had been on continuous and standardized oral anticoagulant therapy for more than three weeks preoperatively.Neurological function tests were performed 24 hours before and after the operation,and cranial MRI was conducted 24-48 hours postoperatively to determine the presence of asymptomatic cerebral embolism.Baseline data,baseline activated clotting time(ACT),intraoperative heparin dosage,mean ACT,operation time,ablation strategy,intraoperative electrical cardioversion ratio,and incidences of perioperative all-cause death,bleeding events,systemic circulation embolism,and ACE were compared between the two groups.Results There were no statistically significant differences in baseline data between the two groups(P>0.05).The baseline ACT level was higher(t=-5.660,P<0.01),and the intraoperative heparin dose was lower(t=2.174,P<0.05)in the anticoagulation group compared with those in the control group.There were no statistically significant differences in mean ACT level,ablation strategy,or electrical cardioversion ratio between the two groups(P>0.05).There was no statistically significant difference in the incidence of perioperative bleeding between the two groups(P>0.05).The incidence of ACE was significantly lower in the anticoagulation group than that in the control group(χ2=6.568,P<0.01).Conclusion Continuous anticoagulation treatment for more than 3 weeks perioperatively can reduce the incidence of postoperative ACE in low-risk AF patients.关键词
心房颤动/导管消融/抗凝/脑栓塞Key words
Atrial fibrillation/Catheter ablation/Anticoagulation/Cerebral embolism引用本文复制引用
王萌,王如兴,杜为,杨浩,费亚兰,韩冰..围手术期不同抗凝策略对低危心房颤动导管消融术后急性脑栓塞发生的影响[J].心脑血管病防治,2025,25(4):5-8,40,5.基金项目
徐州市社会发展重点专项(KC21155) （KC21155）
