零化心房-节点回入性心跳动脉移除
Christina Soether1, Andreas A Boehmer1, Bianca C Dobre1
1Department of Cardiology, St. Josefs-Hospital GmbH, Beethovenstraße 20, 65189, Wiesbaden, Germany.
Herzschrittmachertherapie & Elektrophysiologie
|November 10, 2023
概括
对于心房节节节回入性心力衰竭 (AVNRT) 的零光镜射频导管切除 (RFCA) 是可行的和安全的. 三维电解剖绘图 (3D-EAM) 可以减少辐射暴露,而不会增加手术时间或并发症.
科学领域:
- 电子生理学 电子生理学
- 心血管医学 心血管医学
- 医疗成像医学成像
背景情况:
- 心房节回入性心力衰竭 (AVNRT) 是一种常见的超心室性心力衰竭,特别是在年轻人中.
- 射频导管切除 (RFCA) 是AVNRT的标准治疗方法.
- 传统的RFCA依赖于电离辐射 (光学) 进行导管引导,对患者和工作人员构成风险.
研究的目的:
- 评估对AVNRT进行零光镜RFCA的可行性和安全性.
- 评估EnSiteTM NavXTM三维 (3D) 电解剖学绘图系统 (EAM) 在无辐射废除程序中的实用性.
主要方法:
- 对接受AVNRT-RFCA的68名患者的回顾性分析.
- 传统光镜 (convFluoro,n=30),3D-EAM与零光镜 (zeroFluoro,n=20) 和3D-EAM与转换光镜 (转换Fluoro,n=18) 的比较.
- 分析手术持续时间,光镜时间和剂量以及并发症率.
主要成果:
- 在convFluoro和zeroFluoro组 (74±24分钟与80±26分钟) 之间,程序的持续时间类似.
- 3D-EAM显著减少了光学持续时间 (7±6分钟在转换Fluoro与12±9分钟在ConvFluoro).
- 零案例不涉及辐射;所有手术都显示出高成功率,几乎没有轻微并发症,没有重大不良事件.
结论:
- 对AVNRT的零光镜RFCA是传统方法的安全和可行的替代方案.
- 使用3D-EAM可使大多数患者显著减少辐射.
- 这种方法不会延长手术时间或增加并发症风险.
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