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目的 报告 15例行心脏射频消融术拔管后引起心血管迷走神经反射的诊断及处理。方法 均由右侧股动脉穿刺 ,插入 7F鞘管 ,消融导管逆行插管至左心室二尖瓣环下行射频消融术。结果 15例患者可快速出现严重的血压下降、心动过缓或窦性停搏。经用阿托品静脉注射 ,生理盐水快速静滴 ,严重者静脉注射或滴注多巴胺后患者多在数分钟内心率、血压逐渐恢复正常 ,无一例死亡。结论 心脏射频消融术拔管后可引起严重的血压下降、心动过缓或窦性停搏 ,心血管迷走神经反射为其主要的发生机制 ,及时的诊断和治疗多能很快恢复
Objective To report the diagnosis and treatment of cardiovascular vagal reflex caused by extubation after cardiac radiofrequency ablation in 15 patients. Methods The right femoral artery puncture, insertion of 7F sheath, retrograde catheter ablation catheter to the left ventricular mitral annular radiofrequency ablation. Results 15 patients with rapid rapid decline in blood pressure, bradycardia or sinus arrest. Intravenous injection of atropine, rapid intravenous infusion of saline, severe intravenous injection or infusion of dopamine in patients with heart rate within minutes, blood pressure gradually returned to normal, without any death. Conclusions Cardiac radiofrequency catheter ablation may lead to severe hypotension, bradycardia or sinus arrest, and cardiovascular vagal reflex as its main mechanism of extubation. Prompt diagnosis and treatment can be quickly resumed