Khan Faris, Banchs Javier E, Skibba Joshua B, Grando-Ting Jennifer, Kelleman John, Singh Harjit, Gonzalez Mario D
Penn State Heart & Vascular Institute, Milton S. Hershey Medical Center, Penn State University, 500 University Dr. H047, Hershey, PA, 17033, USA.
J Interv Card Electrophysiol. 2015 Mar;42(2):129-34. doi: 10.1007/s10840-014-9968-x. Epub 2015 Jan 20.
The anatomical reconstruction of the left atrium (LA) and pulmonary veins with fast anatomical mapping (FAM) and intracardiac echocardiography (ICE) using the Carto 3 system (Biosense Webster, Inc) provides real-time guidance to catheter manipulation during ablation of atrial fibrillation (AF). The present study compared real-time LA volume reconstruction using FAM and ICE. In addition, the contribution of respiratory gating was assessed.
LA reconstruction was created using FAM and ICE in 60 consecutive patients (mean age 63 ± 9 years; 38 males) undergoing AF ablation. In the first 30 patients, FAM and ICE were performed without respiratory gating. In the last 30 patients, FAM and ICE were performed with respiratory gating.
LA volumes determined by FAM were larger than those obtained with ICE in the absence of respiratory gating (n = 30; 129.5 ± 44 vs 110 ± 39.7 cm(3); p = 0.001). However, respiratory gating reduced LA volume determined with FAM by 17.7 ± 6.6% resulting in similar LA volumes to those obtained using ICE [n = 30; 100 ± 29.7 (61-154) vs 101.53 ± 40.1 (56-212) cm(3), p = 0.7, NS].
In the absence of respiratory gating, LA volumes determined by FAM are larger than those obtained with ICE. In contrast, with the addition of respiratory gating, both FAM and ICE provide similar real-time LA volumes.
使用Carto 3系统（Biosense Webster公司）通过快速解剖标测（FAM）和心内超声心动图（ICE）对左心房（LA）和肺静脉进行解剖重建，可为房颤（AF）消融过程中的导管操作提供实时指导。本研究比较了使用FAM和ICE进行实时左心房容积重建的情况。此外，还评估了呼吸门控的作用。
对60例连续接受房颤消融的患者（平均年龄63±9岁；38例男性）使用FAM和ICE进行左心房重建。前30例患者在无呼吸门控的情况下进行FAM和ICE检查。后30例患者在有呼吸门控的情况下进行FAM和ICE检查。
在无呼吸门控时，FAM测定的左心房容积大于ICE测定的容积（n = 30；129.5±44 vs 110±39.7 cm³；p = 0.001）。然而，呼吸门控使FAM测定的左心房容积减少了17.7±6.6%，导致其与ICE测定的左心房容积相似[n = 30；100±29.7（61 - 154）vs 101.53±40.1（56 - 212）cm³，p = 0.7，无显著性差异]。
在无呼吸门控时，FAM测定的左心房容积大于ICE测定的容积。相反，加上呼吸门控后，FAM和ICE均可提供相似的实时左心房容积。
