Intracardiac Echocardiography for Detection of Thrombus in the Left Atrial Appendage Comparison With Transesophageal Echocardiography in Patients Undergoing Ablation for Atrial Fibrillation: The Action-Ice I Study
Intracardiac Echocardiography for Detection of Thrombus in the Left Atrial Appendage Comparison With Transesophageal Echocardiography in Patients Undergoing Ablation for Atrial Fibrillation: The Action-Ice I Study
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DOI：
10.1161/circep.113.000504
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发表时间：
2013-12-01
影响因子：
8.4
通讯作者：
Kulakowski, Piotr
中科院分区：
文献类型：
--
作者：
Baran, Jakub;Stec, Sebastian;Kulakowski, Piotr
背景经食管超声心动图（TEE）是房颤消融术前排除左心耳（LAA）血栓的金标准。心内超声心动图（ICE）用于辅助房颤消融;然而，它也可用于LAA成像。我们研究的目的是确定ICE是否可以取代TEE，并确定最佳ICE放置LAA visualization.Methods和Results 76例（56名男性，平均年龄559.6岁）房颤消融术的患者在手术前接受TEE，并通过ICE进行LAA评估。将8 F AcuNav探头插入右心房、肺动脉和冠状窦。左心耳结构由对TEE结果不知情的超声心动图医师和电生理学家进行分析。所有患者的ICE探头均位于右心房内，74例患者中有64例（86%）位于肺动脉内，74例患者中有49例（66%）位于冠状窦内。64例患者中56例（87.5%）从肺动脉观察到左心耳，49例患者中13例（26%）从冠状窦观察到左心耳（P
Background Transesophageal echocardiography (TEE) is the gold standard for the exclusion of thrombi in the left atrial appendage (LAA) before ablation for atrial fibrillation. Intracardiac echocardiography (ICE) is used to assist atrial fibrillation ablation; however, it can also be used for LAA imaging. The aim of our study was to determine whether ICE could replace TEE and to identify the optimal ICE placement for LAA visualization.Methods and Results Seventy-six consecutive patients (56 men; mean age, 559.6 years) scheduled for atrial fibrillation ablation underwent TEE before the procedure and LAA assessment by ICE. An 8F AcuNav probe was introduced into right atrium, pulmonary artery, and coronary sinus. LAA structure was analyzed by the echocardiographer and electrophysiologist who were blinded to the results of TEE. ICE probe was positioned in the right atrium in all patients, in the pulmonary artery in 64 of 74 (86%) patients, and in the coronary sinus in 49 of 74 (66%) patients. The LAA was properly visualized in 56 of 64 (87.5%) patients from the pulmonary artery versus 13 of 49 (26%) patients from the coronary sinus (P