低温球囊或射频房颤消融低辐射剂量的独立因素:来自“零透视”登记的结果。

IF 1.3
Pacing and clinical electrophysiology : PACE Pub Date : 2021-11-01 Epub Date: 2021-10-06 DOI:10.1111/pace.14366
Matthieu Gras, Rodrigue Garcia, Victor Waldmann, Vincent Bergère, David Duncker, Tom De Potter, Lukas Fiedler, Francisco Moscoso Costa, Bor Antolič, Jedrzej Kosiuk
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引用次数: 1

摘要

目的:房颤(AF)导管消融是一种常见的手术,在大多数情况下需要使用透视。我们的目的是评估低温球囊或射频消融AF时使用低剂量透视的相关因素。方法:在这个前瞻性的欧洲登记中,中心被要求提供连续房颤消融病例的程序特征。低剂量透视被定义为剂量-面积积(DAP)低于射频组和低温球囊消融组中位剂量。结果:共收集了25个中心638例心房颤动消融手术(射频组n = 492例,低温球囊消融组n = 146例)。射频组和低温球组的中位[IQR] DAP分别为926[349;2092]和1516 [418;3408]cGy*cm2。低温球囊消融组DAP降低的主要相关因素为电生理专用实验室(OR 6.04, 95%CI 1.16-31.54;P = .03)和频繁剂量学报告(OR 21.39, 95%CI 5.43 ~ 98.54;p = .03)。与射频消融组低DAP相关的主要因素是胸部剂量计的使用(OR 12.57, 95% CI 2.88-54.90;P = 0.01),双翼x线设备(OR 3.12, 95%CI 1.89-5.16;结论:这项关于房颤消融期间透视使用的现实研究为欧洲国家目前的实践提供了新的数据。技术进步和透视环境质量是降低房颤消融辐射剂量的主要因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Independent factors of low radiation dose during atrial fibrillation ablation with cryoballoon or radiofrequency: Results from the "Go for zero fluoroscopy" registry.

Aims: Atrial fibrillation (AF) catheter ablation is a common procedure requiring in most cases the use of fluoroscopy. We aimed to evaluate the factors associated with a lower dose of fluoroscopy used during AF ablation with cryoballoon or radiofrequency.

Methods: In this prospective European registry, centers were requested to provide procedural characteristics of consecutive AF ablation cases. Lower doses of fluoroscopy were defined as those with dose-area-product (DAP) under the median dose used in the radiofrequency and the cryoballoon ablation groups.

Results: A total of 638 AF ablation procedures were collected (n = 492 for radiofrequency and n = 146 for cryoballoon ablation groups) in 25 centers. The median [IQR] DAP were 926 [349;2092] and 1516 [418;3408] cGy*cm2 in the radiofrequency and cryoballoon groups, respectively. Main factors associated with lower DAP in cryoballoon ablation group were electrophysiology dedicated laboratory (OR 6.04, 95%CI 1.16-31.54; P = .03) and frequent dosimetry report (OR 21.39, 95%CI 5.43-98.54; P = .03). Main factors associated with lower DAP in the radiofrequency ablation group were the use of a chest dosimeter (OR 12.57, 95% CI 2.88-54.90; P = .01), biplane X-ray equipment (OR 3.12, 95%CI 1.89-5.16; P < .01), university hospital (OR 2.10, 95%CI 1.35-3.25; P = .01), electrophysiology dedicated laboratory (OR 2.45, 95%CI 1.48-4.05; P < .01) and use of contact force enabled catheter (OR 22.60, 95%CI 6.82-74.88; P < .01).

Conclusion: This real-life study of fluoroscopy use during AF ablation provides new data about current practices across European countries. Technological advances and quality of the fluoroscopic environment were the main factors associated with lower radiation dose during AF ablation.

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