Reşit Y Yilancioglu, Oğuzhan E Turan, Umut Inevi, Tamas Tahin, Gabor Szeplaki, Laszlo Geller, Emin E Özcan
{"title":"心房颤动消融术中减少辐射暴露的简单方法：无引线-无apron方法。","authors":"Reşit Y Yilancioglu, Oğuzhan E Turan, Umut Inevi, Tamas Tahin, Gabor Szeplaki, Laszlo Geller, Emin E Özcan","doi":"10.23736/S2724-5683.23.06453-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency catheter ablation (RFCA) is a well-established treatment for atrial fibrillation (AF). Fluoroscopy, a widely used imaging method for RFCA, has significant implications for human health. Although no fluoroscopy or near-zero fluoroscopy strategies have gained popularity, they have limitations, such as long procedure times, additional equipment, and expertise. A simple and cost-effective radiation reduction method is needed for treating AF and is compatible with the daily workflow. We aimed to compare the efficacy and safety of fluoroscopy-free and lead apron-free (LAF) after transseptal puncture AF ablation with conventional ablation (CON).</p><p><strong>Methods: </strong>This retrospective study included all patients who underwent RF catheter AF ablation. The lead apron used for protection was removed immediately before 3D reconstruction of the left atrium (LA) after transseptal puncture (TSP), while fluoroscopy was performed on stand-by and locked-in. The pulmonary vein isolation (PVI) was performed using a 3D mapping system, a multielectrode catheter, and a Smart Touch contact force (CF) sensing catheter, via the lead-apron-free (LAF) method, which is similar to the conventional ablation (CON) method.</p><p><strong>Results: </strong>This study enrolled 152 consecutive patients, with 72 and 80 patients in the LAF and CON groups, respectively. The LAF group demonstrated significantly lower values in total fluoroscopy time (6.9 vs. 14 min, P<0.001) and dose area product (DAP) values (15.4±12.1 vs. 31.5±17.4 G/m<sup>2</sup>, P<0.001) than the CON group. However, there was no significant difference in the total procedure time (83.6±21.1 vs. 77.2±11.4 min, P=0.12) between the two groups. Only four procedures (5.5%) required repositioning of the apron, and no complications were observed with the LAF method. Pulmonary vein isolation was achieved in all patients.</p><p><strong>Conclusions: </strong>The LAF method reduced fluoroscopy use compared with CON, with no change in procedure time or efficacy.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A simple method for radiation exposure reduction during atrial fibrillation ablation: the lead-apron-free approach.\",\"authors\":\"Reşit Y Yilancioglu, Oğuzhan E Turan, Umut Inevi, Tamas Tahin, Gabor Szeplaki, Laszlo Geller, Emin E Özcan\",\"doi\":\"10.23736/S2724-5683.23.06453-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Radiofrequency catheter ablation (RFCA) is a well-established treatment for atrial fibrillation (AF). Fluoroscopy, a widely used imaging method for RFCA, has significant implications for human health. Although no fluoroscopy or near-zero fluoroscopy strategies have gained popularity, they have limitations, such as long procedure times, additional equipment, and expertise. A simple and cost-effective radiation reduction method is needed for treating AF and is compatible with the daily workflow. We aimed to compare the efficacy and safety of fluoroscopy-free and lead apron-free (LAF) after transseptal puncture AF ablation with conventional ablation (CON).</p><p><strong>Methods: </strong>This retrospective study included all patients who underwent RF catheter AF ablation. The lead apron used for protection was removed immediately before 3D reconstruction of the left atrium (LA) after transseptal puncture (TSP), while fluoroscopy was performed on stand-by and locked-in. The pulmonary vein isolation (PVI) was performed using a 3D mapping system, a multielectrode catheter, and a Smart Touch contact force (CF) sensing catheter, via the lead-apron-free (LAF) method, which is similar to the conventional ablation (CON) method.</p><p><strong>Results: </strong>This study enrolled 152 consecutive patients, with 72 and 80 patients in the LAF and CON groups, respectively. The LAF group demonstrated significantly lower values in total fluoroscopy time (6.9 vs. 14 min, P<0.001) and dose area product (DAP) values (15.4±12.1 vs. 31.5±17.4 G/m<sup>2</sup>, P<0.001) than the CON group. However, there was no significant difference in the total procedure time (83.6±21.1 vs. 77.2±11.4 min, P=0.12) between the two groups. Only four procedures (5.5%) required repositioning of the apron, and no complications were observed with the LAF method. Pulmonary vein isolation was achieved in all patients.</p><p><strong>Conclusions: </strong>The LAF method reduced fluoroscopy use compared with CON, with no change in procedure time or efficacy.</p>\",\"PeriodicalId\":1,\"journal\":{\"name\":\"Accounts of Chemical Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":16.4000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Accounts of Chemical Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.23736/S2724-5683.23.06453-0\",\"RegionNum\":1,\"RegionCategory\":\"化学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/3/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CHEMISTRY, MULTIDISCIPLINARY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23736/S2724-5683.23.06453-0","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/29 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}
引用次数: 0
摘要
背景：射频导管消融术（RFCA）是治疗心房颤动（房颤）的一种行之有效的方法。透视是射频导管消融术广泛使用的一种成像方法，对人体健康有重大影响。虽然无透视或近乎零透视的策略已广为流行，但它们也有局限性，例如手术时间长、需要额外的设备和专业知识。治疗房颤需要一种简单、经济有效且符合日常工作流程的减少辐射方法。我们旨在比较经椎管穿刺房颤消融术（CON）与传统消融术（CON）后无透视和无导联围裙（LAF）的疗效和安全性：这项回顾性研究纳入了所有接受射频导管房颤消融术的患者。在经穿刺（TSP）后对左心房（LA）进行三维重建之前，立即去除用于保护的导联围裙，同时在待机和锁定状态下进行透视。使用三维绘图系统、多电极导管和 Smart Touch 接触力（CF）传感导管，通过无导联（LAF）方法进行肺静脉隔离（PVI），该方法与传统消融（CON）方法类似：这项研究连续收治了 152 名患者，其中 LAF 组和 CON 组分别有 72 名和 80 名患者。LAF 组的总透视时间值明显更低（6.9 对 14 分钟，P2，PC 结论：与CON相比，LAF方法减少了透视的使用，但手术时间和疗效没有变化。
A simple method for radiation exposure reduction during atrial fibrillation ablation: the lead-apron-free approach.
Background: Radiofrequency catheter ablation (RFCA) is a well-established treatment for atrial fibrillation (AF). Fluoroscopy, a widely used imaging method for RFCA, has significant implications for human health. Although no fluoroscopy or near-zero fluoroscopy strategies have gained popularity, they have limitations, such as long procedure times, additional equipment, and expertise. A simple and cost-effective radiation reduction method is needed for treating AF and is compatible with the daily workflow. We aimed to compare the efficacy and safety of fluoroscopy-free and lead apron-free (LAF) after transseptal puncture AF ablation with conventional ablation (CON).
Methods: This retrospective study included all patients who underwent RF catheter AF ablation. The lead apron used for protection was removed immediately before 3D reconstruction of the left atrium (LA) after transseptal puncture (TSP), while fluoroscopy was performed on stand-by and locked-in. The pulmonary vein isolation (PVI) was performed using a 3D mapping system, a multielectrode catheter, and a Smart Touch contact force (CF) sensing catheter, via the lead-apron-free (LAF) method, which is similar to the conventional ablation (CON) method.
Results: This study enrolled 152 consecutive patients, with 72 and 80 patients in the LAF and CON groups, respectively. The LAF group demonstrated significantly lower values in total fluoroscopy time (6.9 vs. 14 min, P<0.001) and dose area product (DAP) values (15.4±12.1 vs. 31.5±17.4 G/m2, P<0.001) than the CON group. However, there was no significant difference in the total procedure time (83.6±21.1 vs. 77.2±11.4 min, P=0.12) between the two groups. Only four procedures (5.5%) required repositioning of the apron, and no complications were observed with the LAF method. Pulmonary vein isolation was achieved in all patients.
Conclusions: The LAF method reduced fluoroscopy use compared with CON, with no change in procedure time or efficacy.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
