Piros Katalin, Perge Péter, Salló Zoltán, Herczeg Szilvia, Nagy Vivien Klaudia, Osztheimer István, Merkely Béla, Gellér László, Szegedi Nándor
Cardiology Department, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Front Cardiovasc Med. 2023 Jul 25;10:1185187. doi: 10.3389/fcvm.2023.1185187. eCollection 2023.
Our purpose was to compare the procedural characteristics, success rate, and complication rate of the conventional fluoroscopic (CF) and the zero-fluoroscopic (ZF) approach in patients undergoing catheter ablation of AVNRT or typical atrial flutter (Aflu).
186 consecutive patients with an indication for AVNRT or Aflu ablation were enrolled. Based on the operator's preference, the patients were assigned to either CF or ZF group. In the ZF group EnSite NavX, Carto3, or Rhythmia EAMS were used for catheter guidance.
The median age was 56 (IQR = 42-68) years, 144 patients had AVNRT, and 42 had Aflu ablation. CF approach was chosen in 123 cases, while ZF in 63 cases. ZF approach was used more often in case of AVNRT patients [56 (39%) vs. 7 (17%), = 0.006] and in the case of female patients [43 (68%) vs. 20 (32%), = 0.008]. Acute procedural success was obtained in all cases. There was no difference in the complication rate (1 vs. 1, > 0.99) between the two groups. No difference was found regarding the procedure time between the CF and ZF groups [CF: 55 (46-60) min, ZF 60 (47-65) min; = 0.487] or in the procedure time for the different EAMS [EnSite NavX: 58 (50-63) min, Carto3: 60 (44.5-66.3) min, Rhythmia: 55 (35-69) min; = 0.887]. A similar success rate was seen at the 3-month follow-up in the two groups [41 (100%) vs. 96 (97%); = 0.55].
The ZF approach demonstrated non-inferiority in safety and efficacy compared with CF for the AVNRT and Aflu ablations.
我们的目的是比较接受房室结折返性心动过速（AVNRT）或典型心房扑动（Aflu）导管消融术患者的传统荧光透视（CF）和零荧光透视（ZF）方法的操作特征、成功率和并发症发生率。
连续纳入186例有AVNRT或Aflu消融指征的患者。根据术者的偏好，将患者分为CF组或ZF组。在ZF组中，使用EnSite NavX、Carto3或Rhythmia EAMS进行导管引导。
中位年龄为56（四分位间距=42-68）岁，144例患者患有AVNRT，42例进行了Aflu消融。123例选择CF方法，63例选择ZF方法。ZF方法在AVNRT患者中使用得更频繁[56例（39%）对7例（17%），P=0.006]，在女性患者中也是如此[43例（68%）对20例（32%），P=0.008]。所有病例均获得急性手术成功。两组之间的并发症发生率无差异（1例对1例，P>0.99）。CF组和ZF组之间的手术时间无差异[CF组：55（46-60）分钟，ZF组60（47-65）分钟；P=0.487]，不同EAMS的手术时间也无差异[EnSite NavX：58（50-63）分钟，Carto3：60（44.5-66.3）分钟，Rhythmia：55（35-69）分钟；P=0.887]。两组在3个月随访时的成功率相似[41例（100%）对96例（97%）；P=0.55]。
对于AVNRT和Aflu消融，ZF方法在安全性和有效性方面与CF方法相比显示出非劣效性。
