Cohen T J, Ibrahim B, Lazar J, Rosen J, Klein J
Department of Medicine, Winthrop University Hospital, 259 First Street, Mineola, NY 11501, USA.
J Invasive Cardiol. 1999 Jun;11(6):364-8.
Previous studies have demonstrated the utility of intracardiac echocardiography (ICE) during electrophysiologic procedures including radiofrequency catheter ablation. The purpose of this study was to analyze the initial learning experience with ICE during invasive electrophysiologic procedures.
During a 1-month ICE trial, patients scheduled for radiofrequency catheter ablation underwent concurrent imaging using a 9 French, 9 MHz catheter in the right atrium proximal to important endocardial structures and diagnostic/ablation catheters. The procedure length, fluoroscopy and ICE times were systematically recorded during each procedure. In addition, the images were analyzed and recorded and their utility was evaluated after each case. A case control analysis was also performed.
Seven patients underwent ICE (as part of an ICE trial period) during their electrophysiology study between July 21 and August 13, 1998. This study demonstrated the utility of ICE in identifying radiofrequency catheter tip stability and intracardiac and endocardial structures, including the crista terminalis, coronary sinus, and foramen ovale.
ICE contributes to the electrophysiology arsenal for both diagnostic and therapeutic procedures. In particular, this technique demonstrated a decrease in fluoroscopy time as compared to a case control population. This technique limits radiation to the patient and operator. In addition, endocardial structures, which may be pivotal in diagnosing and treating cardiac arrhythmias, were easily identified. Radiofrequency catheter stability can also be assessed with this technique.
既往研究已证明心腔内超声心动图（ICE）在包括射频导管消融在内的电生理手术过程中的实用性。本研究的目的是分析在侵入性电生理手术过程中使用ICE的初步学习经验。
在为期1个月的ICE试验期间，计划进行射频导管消融的患者在靠近重要心内膜结构和诊断/消融导管的右心房使用9F、9MHz导管进行同步成像。在每个手术过程中系统记录手术时长、透视时间和ICE时间。此外，对图像进行分析和记录，并在每个病例后评估其效用。还进行了病例对照分析。
1998年7月21日至8月13日期间，7例患者在其电生理研究过程中接受了ICE检查（作为ICE试验期的一部分）。本研究证明了ICE在识别射频导管尖端稳定性以及心内和心内膜结构（包括界嵴、冠状窦和卵圆孔）方面的实用性。
ICE为诊断和治疗程序的电生理手段做出了贡献。特别是，与病例对照人群相比，该技术显示透视时间减少。该技术限制了对患者和操作者的辐射。此外，在心内结构在诊断和治疗心律失常中可能起关键作用，很容易识别。该技术还可评估射频导管的稳定性。
