Hepatology research : the official journal of the Japan Society of Hepatology · 2025
Bradycardic Responses During Thermal Ablation for Hepatocellular Carcinoma: Impact of Procedural Pain Severity and Autonomic Imbalance.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Komiyama Yasuyuki, Muraoka Masaru, Iijima Tetsuya, Osawa Leona, Takada Hitomi, Suzuki Yuichiro, Sato Mitsuaki, Takano Shinichi, Maekawa Shinya, Tsuchiya Atsunori, Enomoto Nobuyuki
Аннотация
AIM: Bradycardic responses frequently occur during radiofrequency ablation (RFA) and microwave ablation (MWA) for hepatocellular carcinoma (HCC), but the impact of procedural pain severity and patient-specific factors remains unclear. This study aimed to evaluate the incidence and risk factors for bradycardic responses, focusing on procedural pain and autonomic regulation.
METHODS: This retrospective study included 267 patients with solitary HCC who underwent RFA or MWA between 2019 and 2024. Bradycardic responses were defined as a ≥ 30% decrease in heart rate from baseline or < 50 bpm. Patients were categorized by procedural pain severity using patient-controlled analgesia (PCA) bolus administration. Risk factors for bradycardia were assessed by logistic regression.
RESULTS: Bradycardic responses occurred in 70 patients (26.2%). Severe procedural pain (odds ratio [OR], 2.26 and p = 0.007) and primary HCC (OR, 2.68 and p = 0.002) were independent risk factors. In patients without severe pain, absence of angiotensin II receptor blocker (ARB) use increased bradycardia risk (OR, 0.14 and p = 0.013). Most bradycardic events (61.4%) occurred within 3 min of ablation initiation.
CONCLUSIONS: Bradycardic responses during RFA and MWA are common and linked to procedural pain severity and autonomic imbalance. Comprehensive management, including pain control, medication review, and addressing procedural anxiety through counseling or sedation, may reduce risks and enhance procedural safety.
METHODS: This retrospective study included 267 patients with solitary HCC who underwent RFA or MWA between 2019 and 2024. Bradycardic responses were defined as a ≥ 30% decrease in heart rate from baseline or < 50 bpm. Patients were categorized by procedural pain severity using patient-controlled analgesia (PCA) bolus administration. Risk factors for bradycardia were assessed by logistic regression.
RESULTS: Bradycardic responses occurred in 70 patients (26.2%). Severe procedural pain (odds ratio [OR], 2.26 and p = 0.007) and primary HCC (OR, 2.68 and p = 0.002) were independent risk factors. In patients without severe pain, absence of angiotensin II receptor blocker (ARB) use increased bradycardia risk (OR, 0.14 and p = 0.013). Most bradycardic events (61.4%) occurred within 3 min of ablation initiation.
CONCLUSIONS: Bradycardic responses during RFA and MWA are common and linked to procedural pain severity and autonomic imbalance. Comprehensive management, including pain control, medication review, and addressing procedural anxiety through counseling or sedation, may reduce risks and enhance procedural safety.