干预性电生理学手术的外科手术安全性在八代人和非老年人中
Vanessa Sciacca1,2, Jakob Feldt1,2, Laura Rottner1,3
1Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.
Journal of cardiovascular electrophysiology
|May 27, 2025
概括
在80岁及以上的患者中,侵入性电生理学程序是可行的,但具有较高的轻微并发症风险. 对于接受这些心律失常治疗的老年人来说,仔细评估风险和益处是至关重要的.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 老年医学 老年医学
背景情况:
- 导管切除是心律失常的标准治疗方法.
- 80岁及以上患者的侵入性电生理学 (EP) 程序的数据有限.
研究的目的:
- 评估80岁和50岁以外的患者的侵入性EP手术的安全性和可行性.
- 将老年患者的并发症率与年轻的对照组进行比较.
主要方法:
- 对486名年龄≥80岁的患者进行了回顾性研究,这些患者接受了导管切除或左心房尾关闭.
- 与480名年龄小于80岁的患者的匹配对照组进行了比较.
- 程序包括心房动治疗,洞腔柱静脉移除,心室心律失常移除和左心房附属物关闭.
主要成果:
- 老年患者 (平均年龄为82.7岁) 接受了566次手术,而对照组 (平均年龄为64.1岁) 接受了566次手术.
- 轻微并发症的发生率在老年人群中明显高 (5.1%对20%,p=0.039).
- 在老年人群中观察到更严重的并发症 (5.7%对3.5%) 和医院内死亡 (1.1%对0.2%) 的趋势,尽管在统计学上并不显著.
结论:
- 侵袭性EP手术在八十岁和非六十岁的人群中是可行的.
- 老年患者出现较高的轻微周围手术并发症发生率和更严重的结果趋势.
- 在对老年患者进行侵入性EP手术之前,建议进行个性化风险益处评估.
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