Kesek Milos, Wallenius Niklas, Rönn Folke, Höglund Niklas, Jensen Steen
Department of Cardiology, Heart Centre, University Hospital, S-901 85 Umeå, Sweden.
Europace. 2006 Dec;8(12):1027-30. doi: 10.1093/europace/eul127. Epub 2006 Nov 13.
Radiofrequency (RF) ablation requires placement of several catheters at critical positions. The catheters are positioned with fluoroscopy, resulting in a significant radiation exposure. We have investigated to what degree an intracardiac navigation system reduces the fluoroscopy duration in different groups of routine RF ablations.
The fluoroscopy time was evaluated in 365 consecutive routine RF ablations, performed between 2002 and 2005. An intracardiac navigation system (LocaLisa, Medtronic) was used from 2003. The data were prospectively entered into a database and subsequently retrieved, and the procedures classified as being performed with fluoroscopy only or with the aid of the LocaLisa system. After introduction of the LocaLisa system, the median fluoroscopy time decreased from 24 to 10 min in the 141 atrioventricular nodal re-entry tachycardia (AVNRT) ablations and from 43 to 28 min in the 71 atrial flutter (AFl) ablations (P<0.005 for both). In the 145 Wolff-Parkinson-White (WPW) ablations, a decrease from 27 to 23 min was observed (P=0.03). The decrease in AVNRT and AFl, but not in WPW was associated with the introduction of the LocaLisa system.
The use of the LocaLisa system during RF ablations significantly reduced the fluoroscopy time in AVNRT and AFl ablations, by a median of 58% and 46%, respectively.
射频消融需要在关键位置放置多个导管。导管通过荧光透视定位,这会导致大量辐射暴露。我们研究了心脏内导航系统在不同组常规射频消融中能在多大程度上减少荧光透视时间。
对2002年至2005年间连续进行的365例常规射频消融的荧光透视时间进行了评估。自2003年起使用心脏内导航系统(美敦力公司的LocaLisa)。数据被前瞻性地录入数据库,随后进行检索,并将手术分类为仅使用荧光透视或借助LocaLisa系统进行。引入LocaLisa系统后,在141例房室结折返性心动过速(AVNRT)消融中,荧光透视时间中位数从24分钟降至10分钟,在71例心房扑动(AFl)消融中,从43分钟降至28分钟(两者P均<0.005)。在145例预激综合征(WPW)消融中,观察到从27分钟降至23分钟(P = 0.03)。AVNRT和AFl中荧光透视时间的减少与LocaLisa系统的引入有关,而WPW消融中则不然。
在射频消融过程中使用LocaLisa系统可显著减少AVNRT和AFl消融中的荧光透视时间,中位数分别减少58%和46%。