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The effects of pneumopericardium during epicardial catheter ablation after dry pericardiocentesis on patients with ventricular arrhythmia
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  • Qingyong Chen,
  • Bosen Yang,
  • Zhenggang Lai,
  • Wen Yue,
  • Qing Yang
Qingyong Chen
Sichuan University West China Hospital
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Bosen Yang
Sichuan University West China Hospital
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Zhenggang Lai
The First People's Hospital of Longquanyi District Chengdu
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Wen Yue
Sichuan University West China Hospital
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Qing Yang
Sichuan University West China Hospital

Corresponding Author:[email protected]

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Abstract

Introduction: Pneumopericardium is a rare complication of epicardial ablation after dry pericardiocentesis to treat ventricular arrhythmia (VA); its exact clinical effects on patients are still unclear. The purpose of this study was to evaluate the clinical effects of pneumopericardium during epicardial ablation on patients with VA. Methods and Results: A total of 86 patients with VA who underwent epicardial catheter ablation under local anesthesia at West China Hospital of Sichuan University from August 2012 to March 2021 were enrolled in this study. 22 cases had pneumopericardium, with an incidence rate of 25.6%. and 12 (54.55%) patients complained of dyspnea during the procedure with an average occurrence time of 5.4±3.2 minutes after pericardiocentesis. The blood pressure (BP) decreased significantly, with the mean BP dropping from 119.8/73.2 mmHg to 103.5/64.9 mmHg (p<0.001). None of the cases progressed to tension pneumopericardium. Postoperative follow-up with a median period of 496 days showed that the incidence rate of major adverse cardiovascular events (MACEs), including the composite endpoints of all-cause death, rehospitalization for heart failure, and tachyarrhythmia events, was 65% (n=13) in the pneumopericardium group and 43.4% (n=23) in the non-pneumopericardium group. The Kaplan-Meier survival analysis showed that there was no statistically significant difference in the incidence of MACEs between the two groups (p=0.80). Conclusion: The incidence of pneumopericardium during epicardial ablation was relatively high. However, it can barely progress to tension pneumopericardium and further lead to serious consequences. The occurrence of pneumoperitoneum during the procedure may not significantly affect the long-term prognosis of patients.