Catheter ablation of atrial fibrillation facilitated by preprocedural three-dimensional transesophageal echocardiography : long-term outcome
| Autor: | Felix Gramley, Stephan von Bardeleben, Klaus Kettering |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Clinical Trials Study Three dimensional echocardiography Catheter ablation Atrial fibrillation Pulmonary veins macromolecular substances 030204 cardiovascular system & hematology medicine.disease Three-dimensional echocardiography 03 medical and health sciences 0302 clinical medicine Internal medicine Cardiology cardiovascular system Medicine 030212 general & internal medicine ddc:610 Cardiology and Cardiovascular Medicine business Transesophageal echocardiography |
| Zdroj: | World Journal of Cardiology |
| Popis: | Aim: To evaluate the long-term outcome of catheter ablation of atrial fibrillation (AF) facilitated by preprocedural three-dimensional (3-D) transesophageal echocardiography. Methods: In 50 patients, 3D transesophageal echocardiography (3D TEE) was performed immediately prior to an ablation procedure (paroxysmal AF: 30 patients, persistent AF: 20 patients). The images were available throughout the ablation procedure. Two different ablation strategies were used. In most of the patients with paroxysmal AF, the cryoablation technique was used (Arctic Front Balloon, CryoCath Technologies/Medtronic; group A2). In the other patients, a circumferential pulmonary vein ablation was performed using the CARTO system [Biosense Webster; group A1 (paroxysmal AF), group B (persistent AF)]. Success rates and complication rates were analysed at 4-year follow-up. Results: A 3D TEE could be performed successfully in all patients prior to the ablation procedure and all four pulmonary vein ostia could be evaluated in 84% of patients. The image quality was excellent in the majority of patients and several variations of the pulmonary vein anatomy could be visualized precisely (e.g., common pulmonary vein ostia, accessory pulmonary veins, varying diameter of the left atrial appendage and its distance to the left superior pulmonary vein). All ablation procedures could be performed as planned and almost all pulmonary veins could be isolated successfully. At 48-mo follow-up, 68.0% of all patients were free from an arrhythmia recurrence (group A1: 72.7%, group A2: 73.7%, group B: 60.0%). There were no major complications. Conclusion: 3D TEE provides an excellent overview over the left atrial anatomy prior to AF ablation procedures and these procedures are associated with a favourable long-term outcome. |
| Databáze: | OpenAIRE |
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