Akademik Veri Yönetim Sistemi
18th International Congress of Update in Cardiology and Cardiovascular Surgery, Antalya, Türkiye, 1 - 04 Aralık 2022
BACKGROUND: Today, more complex procedures are used for the treatment of arrhythmias in the electrophysiology (EP) laboratory. Echocardiography is the most widely used imaging technique in EP laboratories for the assessment of these cardiovascular complications. In this study, we aimed to compare Hand-held echo (HHE) with standard echo (SE) to determine if it is safe and fast to use HHE during complex procedures in the EP laboratory.
METHODS: A total of 71 patients who underwent complex EP procedures at a single center were consecutively included in this prospective and observational study, between Jun 15, 2020 and May 15, 2021. Radiofrequency (RF) catheter ablations performed with a three-dimensional mapping system (EnSite Precision™ Cardiac Mapping System) or AF ablations using a second generation cryoballoon were defined as complex electrophysiologic (EP) procedures. HHE (Vscan, GE Vingmed Ultrasound, Horten, Norway) and SE (GE Vingmed Ultrasound with an M3S probe) were performed in all patients by experienced two echocardiographers before and after the procedures. Another blinded echocardiographer revised HHE and SE. Presence and severity of valvular regurgitation, presence or absence of left ventricular thrombus and pericardial effusion were evaluated. At the same time, the duration and starting time (time of device transport, opening time) of the imaging with SE and HHE, duration time of the echocardiographic evaluation, and procedural features were recorded.
RESULTS: In 71 patients (55.5 (42.2-61.0 years); 60.5% male), 75 consecutive complex ablation procedures were included. Procedures include RF catheter ablation for atrial tachycardia (n=10; 13.3%), atrial flutter /AF (n=12; 16%), premature ventricular complexes (n=27; 36%), atrioventricular node (n=1; 1.3%), ischemic VT (n=3, 4%), epicardial ablation for VT in 2 patients with dilated CMP (2.7%) using the EnSite Precision™ Cardiac Mapping System, and cryoballoon ablations for AF (n=20; 26.7%). Transseptal puncture was performed in 27 (36%) procedures. Pericardial effusion developed in 2(2.7%) patients and emergency pericardiocentesis was performed in 2(2.7%) of these patients due to cardiac tamponade. Mean procedure time was 100 (78-120) min and fluoroscopic time was 28 (16-45) min. Femoral haematoma were seen in 2(2.7%) patients. Procedurerelated death or stroke was not observed in any of the patients. When HHE and SE were compared, both the time to reach the echo devices and the evaluation time were found to be significantly shorter with HHE (p<0.05, for all).(Table 1)
CONCLUSION: Based on our findings, we conclude that HHE can be used safely for faster diagnosis and management of
complications during complex electrophysiology procedures.