Left main bronchus as a guide for individualized transseptal puncture using a conventional fluoroscopic approach in cryoballoon ablation of atrial fibrillation
| Autor: | Minxia Zhang, Hexiang Cheng, Ling Tao, Yuan Yuan, Wangwei Yang |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Cardiac Catheterization medicine.medical_specialty transseptal puncture medicine.medical_treatment Catheter ablation 030204 cardiovascular system & hematology Cryosurgery Heart Septal Defects Atrial Pulmonary vein cryoballoon ablation 03 medical and health sciences 0302 clinical medicine Atrial Fibrillation Heart Septum medicine Humans left main bronchus Fluoroscopy Heart Atria 030212 general & internal medicine Prospective cohort study Aged Original Investigation Heart septal defect medicine.diagnostic_test business.industry Atrial fibrillation Cryoablation Middle Aged medicine.disease fluoroscopy Catheter Ablation Female Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Anatolian Journal of Cardiology |
| ISSN: | 2149-2263 |
| DOI: | 10.14744/anatoljcardiol.2018.08566 |
| Popis: | Objective Although imaging modalities, such as transesophageal and intracardiac echocardiography, have helped to improve the safety of atrial transseptal puncture (TSP), fluoroscopy is still traditionally and widely used in TSP. The aim of the present study was to evaluate an individual knack for TSP during cryoballoon ablation of atrial fibrillation (AF) under fluoroscopy. Methods Through the prospective study of 72 cases of patients with paroxysmal or persistent AF admitted for cryoablation in our center, 46 cases using a puncture site toward the bifurcation of the left main bronchus (LMB group) and 26 cases using an anterior-inferior puncture site (AI group) were included in the study. The acute pulmonary vein (PV) isolation success rate, single-procedure success rate, and time-to-effect (TTE) between the two groups were analyzed. Results All PVs were identified and successfully isolated, and there are no differences in the two groups. However, the mean TTE was shorter in the LMB group than in the AI group. Moreover, a higher single-procedure success rate was observed in the LMB group. Conclusion The bifurcation of the LMB can be clearly evaluated in each patient under fluoroscopy and is an anatomical landmark for the location of the left PV. TSP guided by the LMB is a new practical method for choosing individualized transseptal sites for catheter ablation of AF, which can help to shorten TTE and procedure time. |
| Databáze: | OpenAIRE |
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