2022, Número 3
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Cardiovasc Metab Sci 2022; 33 (3)
Reducción de la exposición a la radiación en un laboratorio de electrofisiología con el módulo CARTO-UNIVU™
Tinoco M, Cardoso F, Leite S, Calvo L, Sanfins V, Ribeiro S, Lourenço A
Idioma: Inglés [English version]
Referencias bibliográficas: 18
Paginas: 126-133
Archivo PDF: 342.10 Kb.
RESUMEN
La ablación por radiofrecuencia es una técnica eficaz y segura para el tratamiento de diferentes tipos de arritmias. La ablación por radiofrecuencia se realiza mediante fluoroscopia, una guía de navegación estándar, que está asociada con la exposición a la radiación y sus efectos nocivos bien reconocidos para los pacientes y para el personal de laboratorio. En la última década, los sistemas de mapeo electroanatómico han experimentado un fuerte desarrollo. A pesar de sus indiscutibles ventajas, no incluyen información obtenida por fluoroscopia en tiempo real. El módulo CARTO-UNIVU™ aborda esta importante limitación, ya que combina imágenes de fluoroscopia con el mapeo eletroanatómico tridimensional (3D) en una sola vista 3D, lo que permite una reducción pronunciada de la exposición a la radiación. Presentamos cuatro casos de nuestra primera experiencia en un solo centro con el nuevo módulo CARTO-UNIVU™.
REFERENCIAS (EN ESTE ARTÍCULO)
Christoph M, Wunderlich C, Moebius S, Forkmann M, Sitzy J, Salmas J et al. Fluoroscopy integrated 3D mapping significantly reduces radiation exposure during ablation for a wide spectrum of cardiac arrhythmias. Europace. 2015; 17 (6): 928-937.
Canpolat U, Faggioni M, Della Rocca DG, Chen Q, Ayhan H, Vu AA et al. State of fluoroless procedures in cardiac electrophysiology practice. J Innov Card Rhythm Manag. 2020; 11 (3): 4018-4029.
Kiah J, Stueve D. The importance of radiation safety for healthcare workers as well as patients. Cath Lab Digest. 2012; 20 (1).
Picano E, Piccaluga E, Padovani R, Antonio Traino C, Grazia Andreassi M, Guagliumi G. Risks related to fluoroscopy radiation associated with electrophysiology procedures. J Atr Fibrillation. 2014; 7 (2): 1044.
Picano E, Vañó E, Rehani MM, Cuocolo A, Mont L, Bodi V et al. The appropriate and justified use of medical radiation in cardiovascular imaging: a position document of the ESC Associations of Cardiovascular Imaging, Percutaneous Cardiovascular Interventions and Electrophysiology. Eur Heart J. 2014; 35 (10): 665-672.
Rodkiewicz D, Kozluk E, Piatkowska A, Gasecka A, Krzeminski K, Opolski G. Efficacy and safety of zero-fluoroscopy approach during catheter ablation of accessory pathway. J Clin Med. 2022; 11 (7): 1814.
Rogers AJ, Brodt CR. Minimizing radiation in the modern electrophysiology laboratory. J Innov Card Rhythm Manag. 2018; 9 (8): 3265-3270.
Skála T, Táborsky M. Electromechanical mapping in electrophysiology and beyond. Cor Vasa. 2015; 57 (6): 470-482.
Blockhaus C, Schmidt J, Kurt M, Clasen L, Müller P, Brinkmeyer C et al. Fluoroscopy integrating technology in a 3D mapping system during ablation of atrial arrhythmias: first experiences. Arch Med Sci. 2018; 14 (4): 794-800.
Cano O, Alonso P, Osca J, Andrés A, Sancho-Tello MJ, Olagüe J et al. Initial experience with a new image integration module designed for reducing radiation exposure during electrophysiological ablation procedures. J Cardiovasc Electrophysiol. 2015; 26 (6): 662-670.
Sporton SC, Earley MJ, Nathan AW, Schilling RJ. Electroanatomic versus fluoroscopic mapping for catheter ablation procedures: a prospective randomized study. J Cardiovasc Electrophysiol. 2004; 15 (3): 310-315.
Kim YH, Chen SA, Ernst S, Guzman CE, Han S, Kalarus Z et al. 2019 APHRS expert consensus statement on three-dimensional mapping systems for tachycardia developed in collaboration with HRS, EHRA, and LAHRS. J Arrhythm. 2020; 36 (2): 215-270.
Marini M, Martin M, Ravanelli D, Del Greco M, Quintarelli S, Guarracini F et al. Extensive use of 3D nonfluoroscopic mapping systems for reducing radiation exposure during catheter ablation procedures: an analysis of 10 years of activity. Biomed Res Int. 2019; 2019: 4217076.
Cano O, Saurí A, Plaza D, Osca J, Sancho-Tello MJ, Rueda J et al. Evaluation of a near-zero fluoroscopic approach for catheter ablation in patients with congenital heart disease. J Interv Card Electrophysiol. 2019; 56 (3): 259-269.
Akbulak RO, Schaffer B, Jularic M, Moser J, Schreiber D, Salzbrunn T et al. Reduction of radiation exposure in atrial fibrillation ablation using a new image integration module: a prospective randomized trial in patients undergoing pulmonary vein isolation: reduced radiation exposure in af ablation. J Cardiovasc Electrophysiol. 2015; 26 (7): 747-753.
Huo Y, Christoph M, Forkmann M, Pohl M, Mayer J, Salmas J et al. Reduction of radiation exposure during atrial fibrillation ablation using a novel fluoroscopy image integrated 3-dimensional electroanatomic mapping system: A prospective, randomized, single-blind, and controlled study. Heart Rhythm. 2015; 12 (9): 1945-1955.
Sakama S, Yagishita A, Sakai T, Morise M, Ayabe K, Amino M et al. Ablation index-guided cavotricuspid isthmus ablation with contiguous lesions using fluoroscopy integrated 3D mapping in atrial flutter. J Interv Card Electrophysiol. 2022; 64 (1): 217-222.
Sommer P, Rolf S, Piorkowski C, Gaspar T, Huo Y, Piedra C et al. Nonfluoroscopic catheter visualization in atrial fibrillation ablation: experience from 375 consecutive procedures. Circ Arrhythm Electrophysiol. 2014; 7 (5): 869-874.