Abstract:
OBJECTIVES:The purpose of this study was to describe our preliminary experience using catheter-based intracardiac echocardiography as an adjunct to biplane fluoroscopy for guiding radiofrequency catheter ablation of atrial arrhythmias in the right side of the heart. BACKGROUND:Catheter ablation requires precise positioning and stable ablation electrode-endocardial contact. This procedure is currently guided by an analysis of intracardiac electrograms and fluoroscopy. However, the use of fluoroscopy does not allow the endocardium and certain anatomic landmarks to be identified and is associated with the hazards of radiation exposure. METHODS:Seventeen symptomatic patients were studied. A 10F 10-MHz intracardiac imaging catheter was used to visualize specific anatomic landmarks in the right atrium for directing the ablation electrode in 15 patients undergoing radiofrequency ablation of 19 arrhythmias and to assist with interatrial septal puncture in 3 patients. RESULTS:Continuous intracardiac imaging was performed for a mean +/- SD of 63.6 +/- 39.2 min and demonstrated distal electrode-endocardial tissue contact in 81 (60%) of 134 radiofrequency applications. Movement of the catheter was demonstrated during 36 (44%), microcavitations during 39 (48%) and thrombus during 15 (19%) of the 81 imaged applications. In 7 of 10 procedures for atrial flutter, successful ablation was directed at anatomic corridors in the right atrium visualized with intracardiac echocardiography. During ablation of atrial tachycardia, imaging identified abnormal atrial anatomy related to previous surgery and guided successful ablation of a reentrant tachycardia circulating around these anatomic obstacles. In two procedures for slow pathway modification of atrioventricular node reentrant tachycardia, intracardiac echocardiography confirmed catheter stability at the tricuspid annulus anterior to the coronary sinus. CONCLUSIONS:During catheter ablation, intracardiac echocardiography augments fluoroscopy by visualizing anatomic landmarks, ensuring stable endocardial contact and assisting in transseptal puncture. Ablation of typical atrial flutter can be successfully directed at anatomic corridors identified using intracardiac imaging.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Chu E,Kalman JM,Kwasman MA,Jue JC,Fitzgerald PJ,Epstein LM,Schiller NB,Yock PG,Lesh MDdoi
10.1016/0735-1097(94)90119-8subject
Has Abstractpub_date
1994-11-01 00:00:00pages
1351-7issue
5eissn
0735-1097issn
1558-3597pii
0735-1097(94)90119-8journal_volume
24pub_type
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journal_title:Journal of the American College of Cardiology
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abstract:OBJECTIVES:This study was undertaken to determine the extent to which cardiovascular specialists are involved with and affected by managed care and to ascertain their attitudes toward it. This survey also served as the follow-up to an initial study on the subject performed by the American College of Cardiology in 1993....
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abstract:OBJECTIVES:We tested the hypothesis that enalaprilat induces preconditioning (PC)-mimetic actions in patients with stable coronary artery disease. BACKGROUND:Angiotensin-converting enzyme (ACE) inhibitors increase the bioavailability of bradykinin, which induces cardiac PC. METHODS:Twenty-two patients undergoing coro...
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更新日期:2007-04-17 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(88)80002-0
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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abstract::Homocysteine has been implicated in promoting atherosclerotic and thrombotic vascular disease. During the last decade, the utility of homocysteine in predicting risk for atherothrombotic vascular disease has been evaluated in several observational studies in a large number of patients. These studies show that the over...
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pub_type: 杂志文章,评审
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更新日期:2006-09-05 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2001-06-01 00:00:00
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更新日期:2015-07-07 00:00:00
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更新日期:1993-08-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(94)90006-x
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更新日期:2014-06-03 00:00:00
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doi:10.1016/s0735-1097(00)00600-8
更新日期:2000-05-01 00:00:00
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doi:10.1016/j.jacc.2003.09.037
更新日期:2004-02-04 00:00:00
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更新日期:2004-04-21 00:00:00
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更新日期:2003-10-15 00:00:00
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更新日期:2017-11-14 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2001-12-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:1990-12-01 00:00:00
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更新日期:2009-04-14 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:1994-11-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2005-05-03 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:1988-07-01 00:00:00
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更新日期:2005-07-19 00:00:00
abstract::A patient is presented with partial absence of the right pulmonary artery, left coronary artery to bronchial artery fistula and systemic arterial desaturation with a patent foramen ovale. The various aspects of the syndrome are discussed and the rationale for nonoperative closure of the foramen is described. ...
journal_title:Journal of the American College of Cardiology
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更新日期:1983-08-01 00:00:00