Department of Cardiology, Institution of Medical Science, Uppsala University, Sweden.
Europace. 2013 Jul;15(7):927-36. doi: 10.1093/europace/eut084. Epub 2013 Jun 1.
Implantations of cardiac devices therapies and ablation procedures frequently depend on accurate and reliable imaging modalities for pre-procedural assessments, intra-procedural guidance, detection of complications, and the follow-up of patients. An understanding of echocardiography, cardiovascular magnetic resonance imaging, nuclear cardiology, X-ray computed tomography, positron emission tomography, and vascular ultrasound is indispensable for cardiologists, electrophysiologists as well as radiologists, and it is currently recommended that physicians should be trained in several imaging modalities. There are, however, no current guidelines or recommendations by electrophysiologists, cardiac imaging specialists, and radiologists, on the appropriate use of cardiovascular imaging for selected patient indications, which needs to be addressed. A Policy Conference on the use of imaging in electrophysiology and device management, with representatives from different expert areas of radiology and electrophysiology and commercial developers of imaging and device technologies, was therefore jointly organized by European Heart Rhythm Association (EHRA), the Council of Cardiovascular Imaging and the European Society of Cardiac Radiology (ESCR). The objectives were to assess the state of the level of evidence and a first step towards a consensus document for currently employed imaging techniques to guide future clinical use, to elucidate the issue of reimbursement structures and health economy, and finally to define the need for appropriate educational programmes to ensure clinical competence for electrophysiologists, imaging specialists, and radiologists.
心脏器械治疗和消融程序的植入常常依赖于准确可靠的成像方式,用于术前评估、术中指导、并发症检测以及患者随访。对于心脏病专家、电生理学家以及放射科医生来说,理解超声心动图、心血管磁共振成像、核心脏病学、X 射线计算机断层扫描、正电子发射断层扫描和血管超声是必不可少的,目前建议医生应接受多种成像方式的培训。然而,对于特定患者适应症的心血管成像的适当应用,目前还没有电生理学家、心脏成像专家和放射科医生的指南或建议,这需要加以解决。因此,欧洲心律协会(EHRA)、心血管成像理事会和欧洲心脏病放射学会(ESCR)联合组织了一次关于影像学在电生理学和设备管理中应用的政策会议,会议代表来自放射学和电生理学的不同专家领域以及影像学和设备技术的商业开发者。会议的目的是评估证据水平的现状,并朝着为当前使用的成像技术制定共识文件迈出第一步,以指导未来的临床应用,阐明报销结构和健康经济学问题,并最终确定需要适当的教育计划,以确保电生理学家、影像专家和放射科医生的临床能力。