Kozluk Edward, Rodkiewicz Dariusz, Piątkowska Agnieszka, Opolski Grzegorz
1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1A, 02-096 Warsaw, Poland.
Cardiol J. 2018;25(3):327-332. doi: 10.5603/CJ.a2017.0065. Epub 2017 Jun 14.
Development of electroanatomical systems make it possible to perform ablations without the use of fluoroscopy. The aim of this study was to evaluate the efficacy and safety of cryoablation pro-cedures without the use of fluoroscopy.
The study group consisted of 45 patients (14 female; age 36 ± 15 years) treated with cry-oablation using the EnSite electroanatomical system: 10 with ventricular extrasystoly from the right ventricle, 6 with the arrhythmogenic site near the left coronary artery, 17 patients with Wolff-Parkinson- -White syndrome (WPW), 2 patients with atrioventricular nodal reentrant tachycardia (AVNRT) type 2, 7 patients with AVNRT type 1, 3 patients with atrial tachycardia.
In 38 of the 45 patients (84%) cryoablation procedure was performed without the use of fluoroscopy. Cryoablation efficacy was 78.9%. In 5 patients unsuccessful cryoablation was fallowed by radiofrequency applications. Finally, efficacy reached 92.1%. There were no deaths. In 1 patient a small adverse event - right bundle branch block was observed after ablation of para-Hisian accessory path-way. No other adverse events were observed. In the long term follow-up efficacy was 89.5%.
Cryoablation using electroanatomical system without the use of fluoroscopy is a safe and efficient procedure and it is a possible alternative in most patients qualified for cryoablation.
电解剖系统的发展使得在不使用荧光透视的情况下进行消融成为可能。本研究的目的是评估不使用荧光透视的冷冻消融手术的疗效和安全性。
研究组由45例患者(14例女性;年龄36±15岁)组成,他们使用EnSite电解剖系统接受冷冻消融治疗:10例右心室室性早搏患者,6例左冠状动脉附近有致心律失常部位的患者,17例预激综合征(WPW)患者,2例2型房室结折返性心动过速(AVNRT)患者,7例1型AVNRT患者,3例房性心动过速患者。
45例患者中有38例(84%)在不使用荧光透视的情况下进行了冷冻消融手术。冷冻消融的疗效为78.9%。5例冷冻消融失败的患者随后进行了射频消融。最终,疗效达到92.1%。无死亡病例。1例患者在希氏旁旁路消融后出现轻微不良事件——右束支传导阻滞。未观察到其他不良事件。长期随访的疗效为89.5%。
使用电解剖系统且不使用荧光透视的冷冻消融是一种安全有效的手术,对于大多数适合冷冻消融的患者来说是一种可能的替代方法。