Value of two left atrium and pulmonary vein stereoscopic imaging reconstruction methods on guiding radiofrequency ablation for atrial fibrillation
10.3760/cma.j.issn.0253-3758.2017.11.007
- VernacularTitle: 左心房及肺静脉两种立体成像方法在心房颤动射频消融术中的应用
- Author:
Ye TIAN
1
;
Song ZHOU
;
Yuehui YIN
;
Yaxi ZHENG
;
Rongpin WANG
;
Xiaoqiao LIU
;
Zhiqin LIU
;
Qifang LIU
;
Wei LIU
;
Jun PANG
;
Zhi JIANG
;
Longhai TIAN
;
Jing HUANG
;
Long YANG
Author Information
1. Department of Cardiology , Guizhou Provincial People′s Hospital, People′s Hospital of Guizhou Medical University, Guiyang 550002, China
- Publication Type:Journal Article
- Keywords:
Atrial fibrillation;
Imaging, three-dimensional;
Catheter ablation
- From:
Chinese Journal of Cardiology
2017;45(11):930-934
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the value of two 3D imaging reconstruction methods for left atria and pulmonary vein on guiding the catheter ablation for atrial fibrillation (AF).
Methods:From January 2014 to January 2017, a total of 100 drug refractory paroxysmal AF patients were divided into left atria direct angiography group (n=50), and indirect angiography group (n=50). 3D CARTO system was applied for mapping and guiding the ablation procedure. Patients assigned to direct angiography group were treated as follows: intraoperative puncture of atrial septum, inject contrast agent directly into the left atrium, conduct left atrial and pulmonary venous rotation angiography, reconstruct three-dimensional image, integrate the image into real-time X-ray system to facilitate circumferential pulmonary vein isolation. Patients assigned into the indirect angiography group were treated as follows: inject contrast agent through the right ventricle, conduct delayed rotation angiography of the left atria and pulmonary vein to guide circumferential pulmonary vein fixation and ablation. The left atrial and pulmonary venous image acquisition, the operation and X-ray exposure time, the success rate and the incidence of complication of the two groups were compared. The patients were followed up for 3-6 months.
Results:General clinical characteristics of the two groups were similar(all P>0.05). Ablation was successful in all 100 patients. The operation time[(112.0±21.4)min vs. (134.0±24.3)min]and X-ray exposure time((10.7±4.7)min vs. (15.8±5.2)min)were significantly lower in direct angiography group than in indirect angiography group (both P<0.01). There was no significant difference between the two groups in the immediate (86%(43/50) vs. 82%(41/50), P=0.59) and short-term (76%(38/50) vs. 72%(36/50), P=0.65) success rate and complication rate (1 aneurysm in the direct angiography group, 1 pericardial tamponade in the indirect angiography group). In-hospital mortality was zero percent.
Conclusion:It is safe and effective method to guide the radiofrequency catheter ablation of paroxysmal atrial fibrillation by reconstruction 3D image of left atrium and pulmonary vein. Compared with indirect angiography group, direct angiography group can improve the imaging quality of left atrium and pulmonary vein, decrease the X-ray exposure time of the ablation procedure.
