[1]林杰 李海瑞 刘美霞 李海鹰.零射线心腔内超声引导下房间隔穿刺的安全性和可行性探讨[J].心血管病学进展,2022,(1):93-96.[doi:10.16806/j.cnki.issn.1004-3934.2022.01.023]
　LIN Jie,LI Hairui,LIU Meixia,et al.Safety and Feasibility of Fluoroscopy-free Atrial Transseptal Puncture Guided by Intracardiac Echocardiography[J].Advances in Cardiovascular Diseases,2022,(1):93-96.[doi:10.16806/j.cnki.issn.1004-3934.2022.01.023]
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零射线心腔内超声引导下房间隔穿刺的安全性和可行性探讨()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2022年1期
页码:
93-96
栏目:
出版日期:
2022-01-25

文章信息/Info

Title:
Safety and Feasibility of Fluoroscopy-free Atrial Transseptal Puncture Guided by Intracardiac Echocardiography
作者:
林杰 李海瑞 刘美霞 李海鹰
(深圳大学总医院心血管内科,广东 深圳 518055)
Author(s):
LIN Jie; LI Hairui; LIU Meixia; LI Haiying
(Department of Cardiology, Shenzhen University General Hospital),Shenzhen 518055,Guangdong,China)
关键词:
零射线; 心腔内超声; 房间隔穿刺
Keywords:
Fluoroscopy-free; Intracardiac echocardiography;  Atrial transseptal puncture
DOI:
10.16806/j.cnki.issn.1004-3934.2022.01.023
摘要:
目的 探讨零射线心腔内超声（ ICE）指引下房间隔穿刺的安全性和可行性。方法 连续入选2 020年6月—2021年3月在深圳大学总医院就诊并行心房颤动射频导管消融术的患者，入选患者按是否采用零射线ICE指引房间隔穿刺分为两组，一组为传统X射线指引房间隔穿刺（传统X射线组），一组为零射线ICE指引房间隔穿刺（ICE组）。记录两组的房间隔穿刺时间、X射线暴露时间、房间隔穿刺成功率以及心包和股静脉并发症指标。结果 研究共入选2 5例患者，其中传统X射线组10例，ICE组15例，两组患者年龄、左室射血分数以及左房大小差异均无统计学意义（P＞0.05）。ICE组有1例患者因右侧膈肌抬高心脏移位而未能完成零射线房间隔穿刺，两组房间隔穿刺的成功率差异无统计学意义（93.3% vs 100%，P＝0.60）。在房间隔穿刺时间上，ICE组较传统X射线组需更长时间[（38.6±6.5）min vs （25.2±2.9）min，P＜0.001]。但ICE组除其中1例患者外均实现了零射线房间隔穿刺，较传统X射线组显著减少了X射线的暴露时间[（9.8±38.0）s vs（148.0±20.8）s，P＜0.001]。ICE组和传统X射线组均成功穿刺房间隔且无心包并发症。ICE组较传统X射线组股静脉穿刺相关并发症差异无统计学意义（13.3% vs 1 0%,P＝0.460）。结论 零射线ICE引导房间隔穿刺安全可行，可显著减少术者和患者的X射线暴露时间。
Abstract:
Objective To explore the safety and feasibility of Fluoroscopy-free Atrial Transseptal Puncture Guided by Intracardiac Echocardiography (ICE) . Methods We were continuously selected for patients who had undergone atrial fibrillation radiofrequency catheter ablation at Shenzhen University General Hospital from June 2020 to March 2021. The selected patients were divided into two groups according to whether or not to use ICE guiding atrial transseptal puncture. One group was traditional X-ray guided transseptal puncture (Traditional X-ray group), another group was fluoroscopy-free ICE guided atrial transseptal puncture (ICE group). The atrial transseptal puncture time, X-ray exposure time, success rate of atrial transseptal puncture, and pericardium and femoral vein complications were recorded in two groups. Results A total of 25 patients were enrolled in the study, including 10 in the traditional X-ray group and 15 in the ICE group. There was no significant difference in age, left ventricular ejection fraction, and left atrium size between the two groups ( P＞0.05). One patient in the ICE group failed to complete the fluoroscopy-free atrial transseptal puncture due to the elevation of the right diaphragm and heart displacement. There was no significant difference in the success rate of atrial transseptal puncture between the two groups (93.3% vs 100%,P＝0.60). In terms of the atrial transseptal puncture time, the ICE group took longer than the traditional X-ray group [(38.6±6.5) min vs (25.2±2.9) min, P＜0.001]. However, except for one patient in the ICE group, fluoroscopy-free atrial transseptal puncture was achieved, which significantly reduced the X-ray exposure time compared with the traditional X-ray group [(9.8±38.0) s vs (148.0±20.8) s, P＜0.001] . Both the ICE group and the traditional X-ray group successfully punctured the atrial septum without pericardial complications. There was no statistically significant difference in femoral vein puncture-related complications between the ICE group and the traditional X-ray group (13.3% vs 10%, P=0.460). Conclusion Fluoroscopy-free atrial transseptal puncture guided by ICE is safe and feasible, and can significantly reduce the X-ray exposure time of the electrophysiologist and the patient.

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更新日期/Last Update: 2022-02-18