Kerut Edmund Kenneth, Hanawalt Curtis, McKinnie James
Heart Clinic of Louisiana, Marrero, Louisiana.
Echocardiography. 2015 Feb;32(2):281-90. doi: 10.1111/echo.12620. Epub 2014 May 10.
We describe our first 20 cases of cryoablation of atrial fibrillation (AF) using transesophageal echocardiography (TEE). Continuous procedural monitoring with TEE by a cardiologist and senior sonographer assists the electrophysiologist in performance of the cryoballoon procedure of AF. Previously using intracardiac echocardiography (ICE) we have found TEE to have better overall procedural imaging, and monitoring for pericardial effusion or thrombus formation. We have found TEE monitoring to be helpful with positioning for interatrial septal (IAS) puncture, catheter tip avoidance of the left atrial appendage (LAA), and guidance of the balloon catheter into each pulmonary vein (PV), with proper positioning within each PV orifice, and documentation of PV occlusion for the cryoballoon procedure. Procedural equipment and the cryoballoon protocol used are presented in detail. The role of TEE imaging during the procedure and in preventing potential dangers is illustrated. It is the goal of this study to demonstrate how the electrophysiology and echocardiography laboratories work together in this cryoablation procedure.
我们描述了使用经食管超声心动图（TEE）对心房颤动（AF）进行冷冻消融的首批20例病例。由心脏病专家和资深超声检查师通过TEE进行连续的手术监测，可协助电生理学家进行AF冷冻球囊手术。此前我们使用心腔内超声心动图（ICE）时发现，TEE具有更好的整体手术成像效果，且能监测心包积液或血栓形成。我们发现TEE监测有助于房间隔（IAS）穿刺的定位、避免导管尖端进入左心耳（LAA），以及引导球囊导管进入每条肺静脉（PV），并在每个PV开口处正确定位，记录冷冻球囊手术中PV的闭塞情况。详细介绍了所使用的手术设备和冷冻球囊方案。阐述了TEE成像在手术过程中的作用以及预防潜在危险的作用。本研究的目的是展示电生理实验室和超声心动图实验室在这种冷冻消融手术中是如何协同工作的。
