Nishiyama Takahiko, Katsumata Yoshinori, Inagawa Kohei, Kimura Takehiro, Nishiyama Nobuhiro, Fukumoto Kotaro, Tanimoto Yoko, Aizawa Yoshiyasu, Tanimoto Kojiro, Fukuda Keiichi, Takatsuki Seiji
Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo 160-8582, Japan.
Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo 160-8582, Japan
Europace. 2015 Apr;17(4):546-51. doi: 10.1093/europace/euu383. Epub 2015 Feb 10.
The left atrial appendage (LAA) represents the major source of cardiac thrombus formation in patients with atrial fibrillation (AF). Phased-array intracardiac echocardiography (ICE) has become available and frequently used during catheter ablation of AF. We attempted to study the feasibility of using ICE for the visualization and evaluation of the LAA from the pulmonary artery (PA) in patients with AF.
Eighty patients with AF undergoing catheter ablation (70 males, 57.5 ± 9.1 years) were included. Transoesophageal echocardiography was performed on the prior day before the catheter ablation, and ICE was performed just before the transseptal puncture during the catheter ablation. The ICE catheter was advanced up into the PA from the femoral vein, where the LAA was clearly and entirely visualized by manipulating the ICE catheter. We compared the degree of spontaneous echo contrast, and the correlation was obtained between the ICE and TEE (κ = 0.534, P < 0.001). Furthermore, the LAA flow velocity (LAA emptying and filling velocities) measured by ICE had a good correlation to that measured by TEE (R = 0.872, P < 0.01 and R = 0.753, P < 0.01, respectively). No patients developed any complications.
The utilization of ICE in the PA is feasible for the observation and evaluation of the LAA.
左心耳（LAA）是心房颤动（AF）患者心脏血栓形成的主要来源。相控阵心内超声心动图（ICE）已可用于AF导管消融术中，并被频繁使用。我们试图研究在AF患者中使用ICE从肺动脉（PA）可视化和评估LAA的可行性。
纳入80例接受导管消融的AF患者（70例男性，年龄57.5±9.1岁）。在导管消融前一天进行经食管超声心动图检查，并在导管消融期间经房间隔穿刺前进行ICE检查。将ICE导管从股静脉推进至PA，通过操作ICE导管可清晰、完整地观察到LAA。我们比较了自发回声增强程度，并得出ICE与TEE之间的相关性（κ=0.534，P<0.001）。此外，ICE测量的LAA流速（LAA排空和充盈速度）与TEE测量的流速具有良好的相关性（分别为R=0.872，P<0.01和R=0.753，P<0.01）。无患者发生任何并发症。
在PA中使用ICE观察和评估LAA是可行的。
