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[三维映射程序中的电磁干扰]

[Electromagnetic interference in 3D-mapping procedures].

作者信息

Güner Fatih, Leitz Patrick, Ellermann Christian, Köbe Julia, Lange Philipp S, Wolfes Julian, Rath Benjamin, Doldi Florian, Willy Kevin, Frommeyer Gerrit, Eckardt Lars

机构信息

Klinik für Kardiologie II-Rhythmologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland.

出版信息

Herzschrittmacherther Elektrophysiol. 2022 Sep;33(3):290-296. doi: 10.1007/s00399-022-00883-7. Epub 2022 Aug 15.

Abstract

Catheter-based ablation is nowadays a safe and widespread procedure for the treatment of cardiac arrhythmia. This requires exact anatomical knowledge both before and during the examination and is an important prerequisite for targeted treatment. At the beginning of the era of interventional catheter-based treatment, fluoroscopy was the only and usual means of visualization, whereas in the middle of the 1990s continuous 3D-mapping systems were developed for the non-fluoroscopic examination of patients. The correct use of these 3‑D systems, which non-fluoroscopically visualize the catheter and mostly identify mechanisms of arrhythmia in great detail, nowadays makes an important contribution to successful interventional catheter treatment of arrhythmia; however, it is not uncommon for patients with ventricular arrhythmia to also carry implanted electronic devices, such as pacemakers, defibrillators or less frequently left ventricular hemodynamic support systems. All implantable devices lead to electromagnetic interferences, which can complicate the diagnostics and treatment during electrophysiological examinations and ablation. This article addresses the adversities and experiences associated with magnet-based 3D systems and implantable electromagnetically active cardiac devices.

摘要

如今,基于导管的消融术是治疗心律失常的一种安全且广泛应用的方法。这在检查前和检查过程中都需要精确的解剖学知识,并且是进行靶向治疗的重要前提。在基于介入导管治疗的时代初期,荧光透视法是唯一且常用的可视化手段,而在20世纪90年代中期,开发了用于对患者进行非荧光透视检查的连续三维标测系统。如今,这些三维系统的正确使用,能够在非荧光透视的情况下可视化导管,并大多能非常详细地识别心律失常机制,这对心律失常的介入导管治疗取得成功做出了重要贡献;然而,室性心律失常患者同时携带植入式电子设备,如起搏器、除颤器或较少见的左心室血流动力学支持系统的情况并不罕见。所有植入式设备都会导致电磁干扰,这可能会使电生理检查和消融过程中的诊断和治疗变得复杂。本文探讨了与基于磁体的三维系统和植入式电磁活性心脏设备相关的不利情况和经验。

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