Clinical Outcomes of Intracardiac Echocardiography-Guided Radiofrequency Catheter Ablation for Atrial Fibrillation: A Retrospective Study

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2025-02-21 DOI:10.1111/echo.70096

Weiying Long, Qingsong He, Shi Chen, Xue Luo, Wucheng Yang, Jia Zheng, Hua Fu

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引用次数: 0

Abstract

Background

Routine radiofrequency catheter ablation relies on x-ray imaging, which may increase the risk of radiation exposure to patients. With the rapid development of intracardiac echocardiography (ICE) technology, it provides a new guidance modality for radiofrequency catheter ablation and shows great potential for application in the treatment of atrial fibrillation (AF).

Objective

To assess the efficacy and safety of intracardiac echocardiography guided radiofrequency catheter ablation for the treatment of AF.

Methods

A retrospective cohort study was used to collect 184 patients who underwent radiofrequency catheter ablation for the treatment of AF from January 2020 to September 2021 in the cardiovascular medicine department of our hospital. According to whether they used ICE or not, they were divided into the ICE group (30 cases) and the non-ICE group (154 cases). The procedure of the intervention, complications during the intervention and follow-up periods, use of early anticoagulation and antiarrhythmic medications, and the success rate of AF ablation 1 year after the intervention were compared between the two groups.

Results

In comparison to the non-ICE group, the septal puncture time (6.27 ± 1.91 min vs. 7.21 ± 2.08 min, p = 0.022), left atrial modeling time (4.93 ± 1.84 min vs. 5.75 ± 1.96 min, p = 0.035), and total ablation time (67.73 ± 2.64 min vs. 73.35 ± 1.96 min, p < 0.001) in the ICE group were significantly reduced. Radiation exposure time (5.09 ± 0.23 min vs. 13.17 ± 0.28 min, p < 0.001) and radiation exposure (33.13 ± 1.99 mGy/cm² vs. 217.6 ± 15.17 mGy/cm², p < 0.001) also were significantly less in the ICE group than in the non-ICE group. The incidence of postintervention nausea and vomiting (3.33% vs. 19.48%, p = 0.032), and hypotension (3.33% vs. 18.83%, p = 0.033) was significantly lower in the ICE group than in the non-ICE group. Furthermore, the proportion using amiodarone in the first 3 months during follow-up was significantly lower for the ICE group than for the non-ICE group (40.00% vs. 63.64%, p = 0.024), and the rate of late recurrence remained unchanged in the ICE group, while there was a trend toward an increase in the rate of late recurrence in the non-ICE group. One year after the operation, the success rates of AF ablation in the ICE group and non-ICE group were 80.00% and 77.92%, and the difference between the groups was not statistically significant (p = 0.825).

Conclusion

ICE-guided radiofrequency catheter ablation is safe and effective in the treatment of AF, and it has potential advantages in terms of ablation time, radiation exposure, complication occurrence, and patient prognosis.

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心内超声心动图引导下射频导管消融治疗心房颤动的临床结果：回顾性研究

常规的射频导管消融依赖于x射线成像，这可能会增加患者的辐射暴露风险。随着心内超声心动图（ICE）技术的快速发展，为射频导管消融提供了一种新的指导方式，在房颤（AF）的治疗中显示出巨大的应用潜力。目的评价超声心动图引导下射频导管消融治疗房颤的有效性和安全性。方法采用回顾性队列研究，收集2020年1月至2021年9月在我院心血管内科行射频导管消融治疗房颤的患者184例医院。根据是否使用ICE分为ICE组（30例）和非ICE组（154例）。比较两组患者干预程序、干预期间并发症及随访时间、早期抗凝及抗心律失常药物使用情况、干预1年后房颤消融成功率。结果与非ice组比较，间隔穿刺时间（6.27±1.91 min vs. 7.21±2.08 min, p = 0.022）、左房造模时间（4.93±1.84 min vs. 5.75±1.96 min, p = 0.035）、总消融时间(67.73±2.64 min vs. 73.35±1.96 min, p <；0.001)，显著降低。辐射暴露时间(5.09±0.23 min vs. 13.17±0.28 min, p <；0.001)和辐射暴露(33.13±1.99 mGy/cm2 vs. 217.6±15.17 mGy/cm2, p <；0.001)， ICE组也显著低于非ICE组。ICE组干预后恶心、呕吐（3.33% vs. 19.48%, p = 0.032）、低血压（3.33% vs. 18.83%, p = 0.033）发生率显著低于非ICE组。此外，ICE组随访前3个月使用胺碘酮的比例明显低于非ICE组（40.00% vs. 63.64%, p = 0.024）， ICE组晚期复发率保持不变，而非ICE组晚期复发率有上升趋势。术后1年，ICE组与非ICE组房颤消融成功率分别为80.00%和77.92%，组间差异无统计学意义（p = 0.825）。结论ice引导下射频导管消融治疗房颤安全有效，在消融时间、辐射暴露、并发症发生、患者预后等方面具有潜在优势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.