A new technique to perform epicardial mapping in the electrophysiology laboratory
A new technique to perform epicardial mapping in the electrophysiology laboratory
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DOI：
10.1111/j.1540-8167.1996.tb00559.x
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发表时间：
1996-06-01
影响因子：
2.7
通讯作者：
Pilleggi, F
中科院分区：
文献类型：
--
作者：
Sosa, E;Scanavacca, M;Pilleggi, F
心外膜标测。导言：心外膜起源部位可能是心内膜射频能量控制复发性室性心动过速不成功的原因。本研究旨在探讨一种新的心外膜标测技术在查加斯病和复发性室性心动过速患者中应用的可行性和安全性。方法与结果：在透视引导下，硬膜外引导针进针至心包间隙，经心包穿刺行心外膜标测。注射中等对比剂以显示针尖的位置，并引入导丝，直到其尖端位于心包间隙内。在心包囊内插入4 mm可偏转的顶端导管，对右、左室心外膜进行标测。分别在手术当天和出院当天进行经胸超声心动图监测。所有患者均达到心包间隙，无并发症。1例患者的电生理学数据显示存在心外膜回路。住院期间无并发症发生。结论：在电生理实验室通过心包穿刺术可以安全地进行心外膜标测。
Epicardial Mapping. Introduction: A possible epicardial site of origin may be the reason for unsuccessful endocardial application of radiofrequency energy to control recurrent ventricular tachycardia. This study tests the feasibility and safety of a new epicardial mapping technique in patients with Chagas' disease and recurrent ventricular tachycardia.Methods and Results: Epicardial mapping was performed through a pericardial puncture as an epidural introducer needle was advanced into the pericardial space under fluoroscopic guidance. Medium contrast was injected to demonstrate the position of the needle tip, and a guidewire was introduced until its tip lay within the pericardial space. A 8-French Hemaquet was advanced and 4-mm deflectable tip catheter introduced into the pericardial sac to map the right and left ventricular epicardium. Transthoracic echocardiographic monitoring was performed on the day of the procedure and on the day of hospital discharge. The pericardial space was reached in all patients with no complications. Electrophysiologic data suggesting the existence of an epicardial circuit was found in one patient. No complications occurred during the hospitalization period.Conclusion: Epicardial mapping can be safely performed through a pericardial puncture in the electrophysiology laboratory.