Macle Laurent, Jaïs Pierre, Scavée Christophe, Weerasooriya Rukshen, Hocini Mélèze, Shah Dipen C, Raybaud Florence, Choi Kee-Joon, Clémenty Jacques, Haïssaguerre Michel
Hôpital Cardiologique du Haut-Lévêque, Avenue de Magellan, 33604 Bordeaux-Pessac, France.
J Cardiovasc Electrophysiol. 2003 Jul;14(7):693-7. doi: 10.1046/j.1540-8167.2003.03012.x.
Catheter ablation for atrial fibrillation (AF) is associated with prolonged fluoroscopy times. We prospectively evaluated the use of the LocaLisa three-dimensional nonfluoroscopic catheter imaging system with the aim of reducing fluoroscopy times during pulmonary vein (PV) disconnection.
Fifty-two patients with AF (47 men and 5 women, mean age 53 +/- 9 years) underwent disconnection of all four PVs guided by a circumferential mapping catheter. The LocaLisa navigation system was used for real-time three-dimensional nonfluoroscopic imaging of the circumferential mapping catheter and ablation catheter electrodes in 26 patients. Procedural parameters were compared with those of a control group consisting of 26 patients in whom only standard fluoroscopy was used. PV disconnection was performed similarly in both groups by circumferential ablation around the ostia, with the endpoint of disconnecting left atrium to PV breakthroughs. The cumulative duration of radiofrequency (RF) energy delivery, procedural time, and fluoroscopy time required for PV disconnection were compared. Successful disconnection was achieved in all PVs, without acute complications. There was no significant difference in cumulative RF energy delivery: 34.8 +/- 11.4 minutes for the nonfluoroscopic imaging group versus 38.2 +/- 10.5 minutes for the control group. The fluoroscopy time required for disconnection of all four PVs was significantly lower in the LocaLisa group than in the control group: 8.4 +/- 4.3 minutes versus 23.7 +/- 9.7 minutes (P < 0.0001). There also was a significant difference in the mean time taken for PV disconnection: 46.5 +/- 12.0 minutes for the nonfluoroscopic imaging group versus 66.3 +/- 18.9 minutes for the control group (P < 0.0001).
By allowing continuous three-dimensional monitoring of ablation and mapping catheter position and orientation, the LocaLisa nonfluoroscopic imaging system significantly reduces fluoroscopy and PV disconnection times.
心房颤动（AF）的导管消融与较长的透视时间相关。我们前瞻性地评估了LocaLisa三维非透视导管成像系统的使用，目的是减少肺静脉（PV）隔离期间的透视时间。
52例AF患者（47例男性和5例女性，平均年龄53±9岁）在环形标测导管引导下进行了所有四条PV的隔离。26例患者使用LocaLisa导航系统对环形标测导管和消融导管电极进行实时三维非透视成像。将操作参数与由26例仅使用标准透视的患者组成的对照组进行比较。两组均通过围绕肺静脉口进行环形消融来进行PV隔离，终点为左心房与PV之间的电传导中断。比较了PV隔离所需的射频（RF）能量输送累积持续时间、操作时间和透视时间。所有PV均成功实现隔离，无急性并发症。累积RF能量输送无显著差异：非透视成像组为34.8±11.4分钟，对照组为38.2±10.5分钟。LocaLisa组隔离所有四条PV所需的透视时间显著低于对照组：8.4±4.3分钟对23.7±9.7分钟（P<0.0001）。PV隔离的平均时间也有显著差异：非透视成像组为46.5±12.0分钟，对照组为66.3±18.9分钟（P<0.0001）。
通过对消融和标测导管的位置和方向进行连续三维监测，LocaLisa非透视成像系统显著减少了透视时间和PV隔离时间。
