Outcome and safety of intracardiac echocardiography guided left atrial appendage closure within zero-fluoroscopy atrial fibrillation ablation procedures

doi:10.1111/jce.15370

科研成果详情

题名	Outcome and safety of intracardiac echocardiography guided left atrial appendage closure within zero-fluoroscopy atrial fibrillation ablation procedures
作者	Chen, Yi-He; Wang, Liang-Guo; Zhou, Xiao-Dong; Fang, Ying; Su, Lan; Wu, Sheng-Jie; Huang, Wei-Jian; Xiao, Fang-Yi
发表日期	2022-04
发表期刊	JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY 影响因子和分区
语种	英语
原始文献类型	Article ; Early Access
关键词	atrial fibrillation catheter ablation intracardiac echocardiography left atrial appendage closure outcomes
其他关键词	TRANSESOPHAGEAL ECHOCARDIOGRAPHY ; CATHETER ABLATION ; STROKE ; PREVENTION ; MANAGEMENT ; OCCLUSION ; GUIDANCE
摘要	Background Simultaneous atrial fibrillation (AF) catheter ablation and left atrial appendage closure (LAAC) are sometimes recommended for both rhythm control and stroke prevention. However, the advantages of intracardiac echocardiography (ICE) guidance for this combined procedure have been scarcely reported. We aim to evaluate the clinical outcomes and safety of ICE-guided LAAC within a zero-fluoroscopy catheter ablation procedure. Methods and Results From April 2019 to April 2020, 56 patients with symptomatic AF underwent concomitant catheter ablation and LAAC. ICE with a multi-angled imaging protocol mimicking the TEE echo windows was used to guide LAAC. Successful radiofrequency catheter ablation and LAAC were achieved in all patients. Procedure-related adverse event rate was 3.6%. During the 12-month follow-up, 75.0% of patients became free of arrhythmia recurrences and oral anticoagulants were discontinued in 96.4% of patients. No ischemic stroke occurred despite two cases of device-related thrombosis versus an expected stroke rate of 4.8% based on the CHA(2)DS(2)-VASc score. The overall major bleeding events rate was 1.8%, which represented a relative reduction of 68% versus an expected bleeding rate of 5.7% based on the HAS-BLED score of the patient cohort. The incidence of iatrogenic atrial septal defect secondary to single transseptal access dropped from 57.9% at 2 months to 4.2% at 12 months TEE follow-up. Conclusion The combination of catheter ablation and LAAC under ICE guidance was safe and effective in AF patients with high stroke risk. ICE with our novel protocol was technically feasible for comprehensive and systematic assessment of device implantation.
资助项目	Research Incubation Project of the First Affiliated Hospital of Wenzhou Medical University [FHY2019069]; Science and Technology of Wenzhou [Y20180647Y20180079]; Key Research and Development Program of Zhejiang [2019C03012]; Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81900229]; Wenzhou Municipal Science and Technology Bureau [Y20180079]
出版者	WILEY
出版地	HOBOKEN
ISSN	1045-3873
EISSN	1540-8167
卷号	33 期号:4 页码:667-676
DOI	10.1111/jce.15370
页数	10
WOS类目	Cardiac & Cardiovascular Systems
WOS研究方向	Cardiovascular System & Cardiology
WOS记录号	WOS:000746816900001
收录类别	SCIE ; PUBMED ; SCOPUS
URL	查看原文
PubMed ID	35040537
SCOPUSEID	2-s2.0-85123534438
通讯作者地址	[Huang, Wei-Jian]Department of Cardiology,The First Affiliated Hospital of Wenzhou Medical University,Zhejiang,Wenzhou,China ; [Xiao, Fang-Yi]Department of Cardiology,The First Affiliated Hospital of Wenzhou Medical University,Zhejiang,Wenzhou,China
Scopus学科分类	Cardiology and Cardiovascular Medicine;Physiology (medical)
引用统计	被引频次：1[WOS] [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/14433
专题	附属第一医院
通讯作者	Huang, Wei-Jian; Xiao, Fang-Yi
作者单位	Department of Cardiology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,China
第一作者单位	附属第一医院
通讯作者单位	附属第一医院
第一作者的第一单位	附属第一医院
推荐引用方式 GB/T 7714	Chen, Yi-He,Wang, Liang-Guo,Zhou, Xiao-Dong,et al. Outcome and safety of intracardiac echocardiography guided left atrial appendage closure within zero-fluoroscopy atrial fibrillation ablation procedures[J]. JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY,2022,33(4):667-676.
APA	Chen, Yi-He., Wang, Liang-Guo., Zhou, Xiao-Dong., Fang, Ying., Su, Lan., ... & Xiao, Fang-Yi. (2022). Outcome and safety of intracardiac echocardiography guided left atrial appendage closure within zero-fluoroscopy atrial fibrillation ablation procedures. JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 33(4), 667-676.
MLA	Chen, Yi-He,et al."Outcome and safety of intracardiac echocardiography guided left atrial appendage closure within zero-fluoroscopy atrial fibrillation ablation procedures".JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY 33.4(2022):667-676.