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常规透视引导与零透视导管消融治疗室上性心动过速。

Conventional fluoroscopy-guided versus zero-fluoroscopy catheter ablation of supraventricular tachycardias.

机构信息

Medical Faculty, University of Ljubljana, Vrazov trg 2, 1104, Ljubljana, Slovenia.

Cardiovascular Surgery Department, University Medical Centre Ljubljana, Zaloska cesta 7, 1000, Ljubljana, Slovenia.

出版信息

BMC Cardiovasc Disord. 2022 Mar 13;22(1):98. doi: 10.1186/s12872-022-02544-6.

Abstract

PURPOSE

The aim of this study was to evaluate the safety and efficacy of zero-fluoroscopy (ZF) catheter ablation (CA) for supraventricular tachycardias (SVT).

METHODS

584 consecutive patients referred to our institution for CA of SVT were analysed. Patients were categorised into two groups; zero-fluoroscopy (ZF) group and conventional fluoroscopy (CF) group. The ZF group was further divided into two subgroups (adults and paediatric). Patient characteristics, procedural information, and follow-up data were compared.

RESULTS

The ZF group had a higher proportion of paediatric patients (42.2% vs 0.0%; p < 0.001), resulting in a younger age (30.9 ± 20.3 years vs 52.7 ± 16.5 years; p < 0.001) and lower BMI (22.8 ± 5.7 kg/m vs 27.0 ± 5.4 kg/m; p < 0.001). Procedure time was shorter in the ZF group (94.2 ± 50.4 min vs 104.0 ± 54.0 min; p = 0.002). There were no major complications and the rate of minor complications did not differ between groups (0.0% vs 0.4%; p = 0.304). Acute procedural success as well as the long-term success rate when only the index procedure was considered did not differ between groups (92.5% vs 95.4%; p = 0.155; 87.1% vs 89.2%; p = 0.422). When repeated procedures were included, the long-term success rate was higher in the ZF group (98.3% vs 93.5%; p = 0.004). The difference can be partially explained by the operators' preferences.

CONCLUSION

The safety and efficacy of ZF procedures in adult and paediatric populations are comparable to that of CF procedures.

摘要

目的

本研究旨在评估零透视(ZF)导管消融(CA)治疗室上性心动过速(SVT)的安全性和疗效。

方法

分析了 584 例连续因 SVT 接受 CA 治疗的患者。患者分为两组:零透视(ZF)组和常规透视(CF)组。ZF 组进一步分为成人和儿科亚组。比较患者特征、手术信息和随访数据。

结果

ZF 组中儿童患者比例较高(42.2%比 0.0%;p<0.001),年龄较小(30.9±20.3 岁比 52.7±16.5 岁;p<0.001),BMI 较低(22.8±5.7 kg/m 比 27.0±5.4 kg/m;p<0.001)。ZF 组的手术时间较短(94.2±50.4 分钟比 104.0±54.0 分钟;p=0.002)。两组均无重大并发症,小并发症发生率无差异(0.0%比 0.4%;p=0.304)。两组急性手术成功率和仅考虑索引手术的长期成功率无差异(92.5%比 95.4%;p=0.155;87.1%比 89.2%;p=0.422)。当包括重复手术时,ZF 组的长期成功率较高(98.3%比 93.5%;p=0.004)。这种差异部分可以由操作者的偏好来解释。

结论

ZF 程序在成人和儿科人群中的安全性和疗效与 CF 程序相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab55/8919640/b1cd1563296e/12872_2022_2544_Fig1_HTML.jpg

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