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接受复发性房颤或房扑左心房消融手术患者食管位置的时间稳定性。

Temporal stability of the location of the esophagus in patients undergoing a repeat left atrial ablation procedure for atrial fibrillation or flutter.

作者信息

Kennedy Robert, Good Eric, Oral Hakan, Huether Elizabeth, Bogun Frank, Pelosi Frank, Morady Fred, Chugh Aman

机构信息

Division of Cardiology, University of Michigan Health System, Ann Arbor, Michigan 48109-0311, USA.

出版信息

J Cardiovasc Electrophysiol. 2008 Apr;19(4):351-5. doi: 10.1111/j.1540-8167.2007.01051.x. Epub 2007 Dec 12.

Abstract

BACKGROUND

The esophagus may be mobile during a left atrial (LA) ablation procedure for atrial fibrillation (AF).

OBJECTIVE

The goal of the study was to determine whether the location of the esophagus is stable in patients undergoing a repeat LA ablation procedure.

METHODS

Forty-two patients underwent repeat LA ablation a mean of 7 +/- 2 months after the initial procedure. Cinefluoroscopic images of the esophagus during a barium swallow were recorded and the course of the esophagus was tagged on the 3D map. The position of the esophagus at the index and repeat procedure were compared.

RESULTS

At the index procedure, the esophagus was located near the left pulmonary veins (PVs) in 20 (48%), right PVs in 13 (31%), and at the mid LA in 9 (21%) patients. During the repeat procedure, the esophagus was found to be near the left PVs in 22 (52%), right PVs in 11 (26%), and at the mid LA in 9 patients (21%). In 35 of the 42 patients (83%), there was no change in the esophageal location, and in the remaining seven patients (17%), its position had shifted by > or =1 cm (range 1.0-4.0 cm).

CONCLUSIONS

In more than 80% of patients presenting for a repeat LA ablation procedure, the esophagus is in the same position relative to the PVs as during the initial procedure. Therefore, if radiofrequency ablation at a particular location was limited by the position of the esophagus, safe ablation at that site is unlikely to be feasible during a repeat procedure.

摘要

背景

在心房颤动(AF)的左心房(LA)消融手术过程中,食管可能会移动。

目的

本研究的目的是确定接受重复LA消融手术的患者中食管位置是否稳定。

方法

42例患者在初次手术后平均7±2个月接受重复LA消融。在吞钡过程中记录食管的荧光透视图像,并在三维地图上标记食管的走行。比较初次手术和重复手术时食管的位置。

结果

在初次手术时,20例(48%)患者的食管位于左肺静脉(PVs)附近,13例(31%)位于右PVs附近,9例(21%)位于左心房中部。在重复手术时,22例(52%)患者的食管位于左PVs附近,11例(26%)位于右PVs附近,9例(21%)位于左心房中部。42例患者中有35例(83%)食管位置无变化,其余7例(17%)位置移动≥1 cm(范围1.0 - 4.0 cm)。

结论

在接受重复LA消融手术的患者中,超过80%的患者食管相对于PVs的位置与初次手术时相同。因此,如果在特定位置的射频消融受到食管位置的限制,那么在重复手术时在该部位进行安全消融不太可能可行。

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