Hanaoka Takeshi, Suyama Kazuhiro, Taguchi Atsushi, Shimizu Wataru, Kurita Takashi, Aihara Naohiko, Kamakura Shiro
First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
Jpn Heart J. 2003 Sep;44(5):673-80. doi: 10.1536/jhj.44.673.
Intracardiac echocardiography (ICE) serves as an adjunct to fluoroscopy for electrophysiological procedures by identifying critical anatomic landmarks and confirming catheter-endocardial contact. In the present study, we investigated the usefulness of ICE for radiofrequency catheter ablation. ICE was utilized to guide transseptal puncture in 19 patients undergoing radiofrequency catheter ablation. The fossa ovalis, which was one critical anatomic landmark, had an average vertical diameter of 18.5 +/- 6.9 mm and an average horizontal diameter of 10.0 +/- 2.4 mm, as measured by ICE and fluoroscopy. Although there was only a small shift of the puncture site in the horizontal direction, the puncture site shifted towards the upper edge of the fossa ovalis for 17 patients (89%). Furthermore, we could verify that the distance between the apex of the tent-shape formed by the pressure of the puncture needle in the fossa ovalis and the left atrial wall opposing it was sufficient to carry out the procedure safely. Confirming the puncture site using ICE is useful in carrying out transseptal left heart catheterization safely.
心内超声心动图（ICE）通过识别关键解剖标志并确认导管与心内膜的接触，辅助荧光透视进行电生理手术。在本研究中，我们调查了ICE在射频导管消融中的实用性。ICE被用于指导19例接受射频导管消融患者的经房间隔穿刺。卵圆窝是一个关键解剖标志，通过ICE和荧光透视测量，其平均垂直直径为18.5±6.9mm，平均水平直径为10.0±2.4mm。尽管穿刺部位在水平方向仅有小的偏移，但17例患者（89%）的穿刺部位移向卵圆窝上缘。此外，我们可以证实，卵圆窝内穿刺针压力形成的帐篷状顶端与相对的左心房壁之间的距离足以安全地进行手术。使用ICE确认穿刺部位有助于安全地进行经房间隔左心导管插入术。
