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目的:探讨肥厚型梗阻性心肌病(HOCM)患者行经皮经腔间隔心肌化学消融术(PTSMA)中发生急性房室传导阻滞对预后的影响。方法:94例行PTSMA的HOCM患者按术中是否发生急性房室传导阻滞分为两组,比较两组患者的预后情况。结果:急性传导阻滞组术后亚急性心脏传导阻滞发生率达57.7%,其中亚急性室内传导阻滞发生率为42.3%、亚急性Ⅰ°房室传导阻滞发生率为7.7%、亚急性完全性房室传导阻滞发生率为7.7%,而非急性传导阻滞组术后亚急性心脏传导阻滞发生率为25.0%,其中室内传导阻滞发生率为20.6%、Ⅰ°房室传导阻滞发生率为2.9%、亚急性完全性房室传导阻滞发生率为1.5%,两组术后亚急性心脏传导阻滞发生率比较有统计学差异(P<0.01);急性传导阻滞组传导阻滞平均持续时间为42.00h、非急性传导阻滞组传导阻滞平均持续时间为7.33h,两组术后传导阻滞平均持续时间比较有统计学差异(P<0.01)。结论:PTSMA中出现急性传导阻滞的患者,术后容易继发亚急性传导阻滞,尤其是室内传导阻滞,而且传导系统恢复时间较长;而术中未出现传导阻滞的患者,即使术后出现亚急性传导阻滞,其传导系统亦恢复较快。
Objective: To investigate the effect of acute atrioventricular block on percutaneous transluminal myocardial septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods: Ninety-four HOCM patients undergoing PTSMA were divided into two groups according to whether acute AV block occurred during operation. The prognosis of the two groups were compared. Results: The incidence of subacute heart block in acute block group was 57.7%. The incidence of subacute intercurrent block was 42.3% in subacute. The incidence of subacute Ⅰ ° atrioventricular block was 7.7% The incidence of acute complete atrioventricular block was 7.7%, while the incidence of subacute heart block in non-acute block was 25.0%, of which the incidence of indwelling block was 20.6%. The incidence of Ⅰ ° atrioventricular The incidence of conduction block was 2.9%, the incidence of subacute complete AV block was 1.5%, and the incidence of subacute heart block was significantly different between the two groups (P <0.01). Acute conduction resistance The mean duration of conduction block was 42.00 hours in hysteresis group and 7.33 hours in non-acute conduction block group. The average duration of conduction block was significantly different between the two groups (P <0.01). CONCLUSIONS: Patients with acute conduction block in PTSMA are likely to have subacute conduction block, especially indwelling conduction block, and the conduction system has a longer recovery time after operation. Patients without conduction block during operation, Subacute conduction block occurred after operation, and the conduction system also recovered quickly.