Academic Journal
Catheter navigation by intracardiac echocardiography enables zero-fluoroscopy linear lesion formation and bidirectional cavotricuspid isthmus block in patients with typical atrial flutter
| العنوان: | Catheter navigation by intracardiac echocardiography enables zero-fluoroscopy linear lesion formation and bidirectional cavotricuspid isthmus block in patients with typical atrial flutter |
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| المؤلفون: | Blerim Luani, Maksim Basho, Ammar Ismail, Thomas Rauwolf, Sven Kaese, Ndricim Tobli, Alexander Samol, Katharina Pankraz, Alexander Schmeisser, Marcus Wiemer, Rüdiger C. Braun-Dullaeus, Conrad Genz |
| المصدر: | Cardiovascular Ultrasound, Vol 21, Iss 1, Pp 1-9 (2023) |
| بيانات النشر: | BMC |
| سنة النشر: | 2023 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | Catheter ablation, Cavotricuspid isthmus, Zero-fluoroscopy, Intracardiac echocardiography, Diseases of the circulatory (Cardiovascular) system, RC666-701 |
| الوصف: | Introduction One of the most helpful aspects of intracardiac echocardiography (ICE) implementation in electrophysiological studies (EPS) is the real-time visualisation of catheters and cardiac structures. In this prospective study, we investigated ICE-guided zero-fluoroscopy catheter navigation during radiofrequency (RF) ablation of the cavotricuspid isthmus (CTI) in patients with typical atrial flutter (AFL). Methods and results Thirty consecutive patients (mean age 72.9 ± 11.4 years, 23 male) with ongoing (n = 23) or recent CTI-dependent AFL underwent an EPS, solely utilizing ICE for catheter navigation. Zero-fluoroscopy EPS could be successfully accomplished in all patients. Mean EPS duration was 41.4 ± 19.9 min, and mean ablation procedure duration was 20.8 ± 17.1 min. RF ablation was applied for 6.0 ± 3.1 min (50W, irrigated RF ablation). Echocardiographic parameters, such as CTI length, prominence of the Eustachian ridge (ER), and depth of the CTI pouch on the ablation plane, were assessed to analyse their correlation with EPS- or ablation procedure duration. The CTI pouch was shallower in patients with an ablation procedure duration above the median (4.8 ± 1.1 mm vs. 6.4 ± 0.9 mm, p = 0.04), suggesting a more lateral ablation plane in these patients, where the CTI musculature is stronger. CTI length or ER prominence above the respective median did not correlate with longer EPS duration. Conclusions Zero-fluoroscopy CTI ablation guided solely by intracardiac echocardiography in patients with CTI-dependent AFL is feasible and safe. ICE visualisation may help to localise the optimal ablation plane, detect and correct poor tissue contact of the catheter tip, and recognise early potential complications during the ablation procedure. Graphical Abstract |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1476-7120 |
| Relation: | https://doi.org/10.1186/s12947-023-00312-w; https://doaj.org/toc/1476-7120; https://doaj.org/article/8a062cdbb3344cc88f88ace8aa03c8df |
| DOI: | 10.1186/s12947-023-00312-w |
| الاتاحة: | https://doi.org/10.1186/s12947-023-00312-w https://doaj.org/article/8a062cdbb3344cc88f88ace8aa03c8df |
| رقم الانضمام: | edsbas.F2BBE739 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 14767120 |
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| DOI: | 10.1186/s12947-023-00312-w |