ABSTRACT
Objective To explore the feasibility and effectiveness of 3D electroanatomical navigation system(CARTO3)-guided catheter ablation for idiopathic right ventricular outflow tract premature ventricular contractions(RVOT-PVCs). Methods A total of 49 consecutive patients with RVOT-PVCs undergoing catheter ablation were divided into two groups: 3D group received CARTO3-guided ablation (n=29) and the conventional group received X-Ray-guided ablation (n=20). The operation time, X-ray fluoroscopy time, X-ray fluoroscopy exposure, cost, complication, successfully rates and recurrence rates were compared between the two groups. Results The immediate success rates were 100% (29/29) in the 3D group and 95% (19/20) in the conventional group. Complications were found in 3 cases in the conventional group and not found in the 3D group. Fluoroscopy time of 3D group was significantly shorter than that of the X-Ray group([1.3±3.6] min vs [44.2±28.2] min, P<0.01), and the radiation dose was also significantly lower than that of the X-Ray group ([93±242] mGy vs [3 919±2 309] mGy, P<0.01), but the 3D group had significantly higher cost compared with the X-Ray group (P<0.01). There was no significant difference in the total operation time lengths between the two groups. Twenty(69.0%) of the 29 cases in the 3D group avoided fluoroscopy entirely. Conclusion Our study indicates that CARTO 3 system is safe and effective in guiding ablation for patients with RVOT-PVCs; the method can greatly reduce fluoroscopy time and fluoroscopy dose, and in many cases non-fluoroscopic radiofrequency catheter ablation(RFCA)can be achieved.
ABSTRACT
Objective To explore the risk factors of in-hospital death of acute myocardial infarction (AMI) patients following percutaneous cornary intervenion (PCI). Methods We retrospectively analyzed the clinical data of 275 AMI patients, including the general condition, medical history, admission, intra- and post-operation condition, and complication. The patients underwent PCI in our hospital from January 2009 to September 2011. Logistic regression analysis was used to predict the risk factor of in-hospital death of AMI patients following PCI. Results Logistic regression analysis found that female sex (P = 0.047, OR = 2. 91), extensive anterior myocardial infarction (P = 0. 044, OR = 3. 07), history of renal insufficiency (P = 0. 021, OR = 7. 98), cardiogenic shock (P = 0. 008, OR = 15. 71), postoperative thrombolysis in myocardial infarction (TIMI) flow grade <3 (P = 0.016, OR = 5. 61), and placement of the intra-aortic balloon pumpdABP, P = 0. 043,Oi? = 3. 49) were associated with an increased risk of in-hospital mortality of AMI patients following PCI. Conclusion Female sex, extensive anterior myocardial infarction, placement of the IABP, postoperative TIMI flow grade <3, history of renal insufficiency, and cardiogenic shock are the risk factors of in-hospital death of AMI patients following PCI.