University Hospital Rangueil, 31059 Toulouse, France; Unité Inserm U1048, 31432 Toulouse, France.
University Hospital of Grenoble-Alpes, 38700 La Tronche, France.
Arch Cardiovasc Dis. 2019 Jan;112(1):67-73. doi: 10.1016/j.acvd.2018.05.006. Epub 2018 Aug 27.
The introduction of catheter ablation techniques has vastly improved the treatment of cardiac arrhythmias. However, as complex ablations are technically demanding and can cause various complications, they require a high level of expertise to maximize success rates and minimize complication rates. As French recommendations regarding the required technical competence and equipment are not yet available, this position paper has been compiled by the Working Group of Pacing and Electrophysiology of the French Society of Cardiology, detailing the required features of an interventional cardiac electrophysiological centre for complex ablation procedures: (1) sufficient institutional volume; (2) physician training, qualifications and experience; (3) paramedical staff training and attendance; and (4) institutional facilities and technical equipment. The importance of being able to diagnose, monitor and manage complications associated with complex ablations is highlighted. Supplemental hospital-based resources are also discussed, such as anaesthesia, surgical back-up, intensive care, haemodynamic assistance and imaging. Further, the ideal features of an interventional cardiac electrophysiology training centre are considered. Lastly, the need for quality evaluations and national registries for complex ablations is discussed.
导管消融技术的引入极大地改善了心律失常的治疗效果。然而，由于复杂的消融术在技术上要求较高，并可能导致各种并发症，因此需要高度的专业知识，以最大限度地提高成功率并降低并发症发生率。由于法国尚未就所需的技术能力和设备提出建议，因此这份立场文件由法国心脏病学会起搏和电生理工作组编写，详细说明了复杂消融手术所需的介入性心脏电生理中心的特征：（1）足够的机构容量；（2）医生的培训、资质和经验；（3）辅助医疗人员的培训和出勤；（4）机构设施和技术设备。强调了能够诊断、监测和处理与复杂消融术相关并发症的重要性。还讨论了补充的医院资源，如麻醉、手术支持、重症监护、血液动力学辅助和影像学。此外，还考虑了介入性心脏电生理培训中心的理想特征。最后，讨论了对复杂消融术进行质量评估和国家登记的必要性。
