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导管消融治疗室性心律失常的长期疗效:比较使用和不使用心内超声心动图的技术——什么重要?

Long-term outcomes of catheter ablation for ventricular arrhythmias: comparing techniques with and without intracardiac echocardiography - what matters?

机构信息

Department of Cardiology, Peking University First Hospital, Beijing, China.

State Key Laboratory for Innovation and Transformation of Luobing Theory, Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, No. 107 Wenhuaxi Road, Jinan, 250012, China.

出版信息

BMC Cardiovasc Disord. 2024 Jul 26;24(1):386. doi: 10.1186/s12872-024-04056-x.

Abstract

BACKGROUND

The increasing use of intracardiac echocardiography (ICE) in the ablation of premature ventricular complexes (PVCs) has raised questions about its true efficacy and safety.

METHODS

This retrospective study collected the periprocedural complications and PVC burden post ablation. The risk factors of PVC recurrence was further explored.

RESULTS

The study included patients treated without ICE (control group, n = 451) and with ICE (ICE group, n = 155) from May 2019 to July 2022. The ICE group demonstrated significantly lower fluoroscopy times and X-ray doses. There were no major complications in the ICE group, and the difference in the occurrence of periprocedural complications between the groups was not statistically significant (p = 0.072). The long-term success rates were similar for the control and ICE groups (89.6% and 87.1%, respectively). The origin of PVCs was identified as the independent factor for ablation success.

CONCLUSIONS

The use of ICE did not confer an advantage with regard to long-term success in PVCs ablation. To thoroughly evaluate the safety and effectiveness of ICE in PVCs ablation, a prospective, multicenter, randomized study is warranted.

摘要

背景

腔内超声心动图(ICE)在心室内早搏(PVCs)消融中的应用日益增多,这引发了对其真正疗效和安全性的质疑。

方法

本回顾性研究收集了消融前后的围手术期并发症和 PVC 负荷。进一步探讨了 PVC 复发的危险因素。

结果

研究纳入了 2019 年 5 月至 2022 年 7 月期间未使用 ICE(对照组,n=451)和使用 ICE(ICE 组,n=155)治疗的患者。ICE 组的透视时间和 X 射线剂量明显较低。ICE 组未发生重大并发症,两组围手术期并发症的发生率无统计学差异(p=0.072)。对照组和 ICE 组的长期成功率相似(分别为 89.6%和 87.1%)。PVCs 的起源被确定为消融成功的独立因素。

结论

ICE 的使用并不能提高 PVCs 消融的长期成功率。为了彻底评估 ICE 在 PVCs 消融中的安全性和有效性,需要进行前瞻性、多中心、随机研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87a6/11282682/df2d4c48398d/12872_2024_4056_Fig1_HTML.jpg

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