Safety of continuous left atrial phased-array intracardiac echocardiography during left atrial ablation for atrial fibrillation.
Safety of continuous left atrial phased-array intracardiac echocardiography during left atrial ablation for atrial fibrillation.
复制标题
在左心消融期间，左室阵列阵列的距离左侧阵列的安全性超声心动图的安全性。
DOI：
10.1016/j.hroo.2022.08.001
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发表时间：
2022-12
期刊：
影响因子：
--
通讯作者：
Bahnson, Tristram D.
中科院分区：
文献类型：
--
作者：
Jackson, Larry R., II;Holmqvist, Fredrik;Parish, Alice;Green, Cynthia L.;Piccini, Jonathan P.;Bahnson, Tristram D.
关键词：
使用射频消融（RFA）进行肺静脉（PV）隔离治疗房颤（AF）需要在PV窦处输送连续的透壁损伤，同时避免损伤食管。左心房（LA）内的连续二维相控阵心内超声心动图（ICE）可提供消融期间导管头端接触和位置的一致高分辨率图像。本研究的目的是比较在左心房内使用和不使用ICE成像的治疗性房颤消融术的近期安全性结局。该研究队列包括590例连续接受房颤射频消融的患者，包括在右心房（RA）或左心房内消融期间进行连续ICE成像。对受试者进行前瞻性随访，确定并记录30天内的围手术期并发症。所有受试者均接受RA ICE成像以指导经中隔导管插入术。243例患者（41.2%）同时使用了右心房和左心房的超声成像。LA与仅RA成像队列在年龄方面相当（中位年龄64 [四分位距57.4 - 71.2]岁vs 64 [56.2 - 70.6]岁; P = 0.425）;高血压史（64.0% vs 67.2%; P = 0.421）;糖尿病（23.1% vs 19.4%; P = 0.268）;既往脑血管意外/短暂性脑缺血发作（10.8% vs 8.4%; P = 0.331）; AF类型（P = 0.241）。两个队列之间30天内的重大并发症无显著差异（P = 0.649），未发现食管或膈神经损伤或肺静脉狭窄病例。常规连续LA ICE成像似乎是安全的，并有可能在射频消融治疗AF期间促进病变输送。
Pulmonary vein (PV) isolation using radiofrequency ablation (RFA) to treat atrial fibrillation (AF) requires delivery of contiguous transmural lesions at the PV antra while avoiding injury to the esophagus. Continuous 2-dimensional phased-array intracardiac echocardiography (ICE) from within the left atrium (LA) can provide consistent high-resolution images of catheter tip contact and location during ablation. The purpose of this study was to compare near-term safety outcomes of therapeutic AF ablation with and without ICE imaging from within the LA. The study cohort included 590 consecutive patients undergoing RFA for AF including continuous ICE imaging during ablation from within either the right atrium (RA) or the LA. Subjects were followed prospectively, and periprocedural complications within 30 days were identified and recorded. All subjects had RA ICE imaging to guide transseptal catheterization. Ultrasound imaging from both RA and LA was used in 243 (41.2%). Respectively, the LA vs RA only imaging cohorts were comparable with respect to age (median 64 [interquartile range 57.4–71.2] years vs 64 [56.2–70.6] years; P = .425); history of hypertension (64.0% vs 67.2%; P = .421); diabetes mellitus (23.1% vs 19.4%; P = .268); previous cerebrovascular accident/transient ischemic attack (10.8% vs 8.4%; P = .331); and AF type (P = .241). There were no significant differences in major complications within 30 days between the 2 cohorts (P = .649) and no identified cases of esophageal or phrenic nerve injury or PV stenosis. Routine continuous LA ICE imaging seems to be safe and holds potential to facilitate lesion delivery during RFA for AF.
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影响因子：
6.2
作者：
Masson, Jean-Bernard;Kouz, Remi;Raymond, Jean-Marc
通讯作者：
Raymond, Jean-Marc
DOI：
10.1016/s0735-1097(02)01893-4
发表时间：
2002-06-19
影响因子：
24
作者：
Mangrum, JM;Mounsey, JP;Haines, DE
通讯作者：
Haines, DE
DOI：
10.1046/j.1540-8167.2004.04428.x
发表时间：
2004-11-01
影响因子：
2.7
作者：
Verma, A;Marrouche, NF;Natale, A
通讯作者：
Natale, A
影响因子：
2.3
作者：
Aguirre, Daniel;Pincetti, Christian;Maluenda, Gabriel
通讯作者：
Maluenda, Gabriel
DOI：
10.1016/0735-1097(94)90119-8
发表时间：
1994-11-01
影响因子：
24
作者：
CHU, E;KALMAN, JM;LESH, MD
通讯作者：
LESH, MD