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中国无氟心脏电生理实验室建设及相关技术专家共识

Chinese expert consensus on the construction of the fluoroless cardiac electrophysiology laboratory and related techniques.

机构信息

Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

出版信息

Pacing Clin Electrophysiol. 2023 Sep;46(9):1035-1048. doi: 10.1111/pace.14782. Epub 2023 Aug 12.

Abstract

Transcatheter radiofrequency ablation has been widely introduced for the treatment of tachyarrhythmias. The demand for catheter ablation continues to grow rapidly as the level of recommendation for catheter ablation. Traditional catheter ablation is performed under the guidance of X-rays. X-rays can help display the heart contour and catheter position, but the radiobiological effects caused by ionizing radiation and the occupational injuries worn caused by medical staff wearing heavy protective equipment cannot be ignored. Three-dimensional mapping system and intracardiac echocardiography can provide detailed anatomical and electrical information during cardiac electrophysiological study and ablation procedure, and can also greatly reduce or avoid the use of X-rays. In recent years, fluoroless catheter ablation technique has been well demonstrated for most arrhythmic diseases. Several centers have reported performing procedures in a purposefully designed fluoroless electrophysiology catheterization laboratory (EP Lab) without fixed digital subtraction angiography equipment. In view of the lack of relevant standardized configurations and operating procedures, this expert task force has written this consensus statement in combination with relevant research and experience from China and abroad, with the aim of providing guidance for hospitals (institutions) and physicians intending to build a fluoroless cardiac EP Lab, implement relevant technologies, promote the standardized construction of the fluoroless cardiac EP Lab.

摘要

经导管射频消融术已广泛应用于快速性心律失常的治疗。随着导管消融推荐水平的提高,对导管消融的需求也在迅速增长。传统的导管消融是在 X 射线的引导下进行的。X 射线可以帮助显示心脏轮廓和导管位置,但电离辐射引起的放射生物学效应以及医务人员穿着厚重防护设备所造成的职业伤害不容忽视。三维标测系统和心腔内超声可以在心脏电生理研究和消融过程中提供详细的解剖学和电生理学信息,还可以大大减少或避免 X 射线的使用。近年来,无氟导管消融技术已在大多数心律失常疾病中得到了很好的验证。一些中心已经报告了在专门设计的无氟电生理导管室(EP 实验室)中进行操作的情况,这些实验室没有固定的数字减影血管造影设备。鉴于缺乏相关的标准化配置和操作程序,该专家工作组结合国内外相关研究和经验撰写了本共识声明,旨在为有意建立无氟心脏 EP 实验室的医院(机构)和医生提供指导,实施相关技术,推动无氟心脏 EP 实验室的标准化建设。

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