Use of Intracardiac Echocardiography for Atrial Flutter Ablation
Chiko, Eitan |
Recenzentas / Reviewer | |
Komisijos pirmininkas / Committee Chairman | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member |
Aim: The aim of the study is to evaluate the usefulness and efficacy of intracardiac echocardiography for atrial flutter ablation
Objectives:
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Determine the possibility of evaluation of cavotricuspid anatomical properties
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Assessment of left atrial thrombus formation, or spontaneous contrast presence prior to the atrial flutter ablation procedure
Methodology: A systematic literature review was carried out through PubMed, and Wiley Online Library electronic databases. The search parameters included the keywords: intracardiac echocardiography, cavotricuspid isthmus, atrial flutter ablation, thrombus identification, management, let atrial appendage, spontaneous echo contrast. The overall database search result yielded 2013 articles of which 41 were reviewed after an inclusion criteria screening was performed, taking into consideration the relevance of the articles to the encompassing aim and objective of this study, as well as the period of those publications, that would not exceed a time frame going back ten years. After the initial screen and review, a total of 23 articles were chosen to be the foundational bases of the review.
Conclusions: ICE used for atrial flutter ablation is a highly effective method for the definitive treatment of Afl. The technique allows for a real-time, intraoperative assessment of the CTI and LAA anatomical properties, is able to identify the presence or occurrence of SEC’s or thrombi, and has an incredibly high success rate, with a low rate of complications. ICE succeeds where other more conventional methods fail or provide equivocal findings. ICE allows for avoidance of radiation, compared with fluoroscopic investigations, does not require anesthesia, and overall shortens the procedural duration and RFA time and exposure. Recommendations: The current scarcity of studies on ICE employment for Afl ablation necessitates more studies to be conducted, ultimately serving as grounds for it being the new “gold standard” in routine practice for Afl ablation treatment.
Nepaisant to, kad pacientai su prieširdžių plazdėjimu vartoja antikoaguliantus, vis dėlto trombozės komplikacijos išlieka. Prieširdžių abliacijos metu – atstatomas sinusinis ritmas, bet pirmasis elektromechaninis kairiosios prieširdžio ausytės susitraukimas gali lemti trombo patekimą į periferines kraujagysles, sukeliant embolizaciją. Papildomas intraoperacinis ištyrimas intrakardine echoskopija gali sumažinti trombembolinių komplikacijų riziką intervencinių procedūrų metu.
Tikslas: Įvertinti intrakardinės echoskopijos naudą prieširdžių plazdėjimo abliacijai.
Uždaviniai:
- Įvertinti kovotrikuspidalinės sąsmaukos anatomiją.
- Įvertinti kairiojo prieširdžio trombozę ar spontaninį kontrastavimą prieš prieširdžių plazdėjimo abliacijos procedūrą.