ABSTRACT
The paper contains comparison of sensitivity and rates of false negative results of transthoracic (TT), transesophageal (TE), and intracardiac (IC) echocardiography (echoCG) during transseptal puncture in the run of the procedure of radiofrequency ablation of atrial fibrillation. In the work fulfilled we analyzed results of 208 echocardiographical intraprocedural investigations conducted with the aim of visualization of interatrial septum (IAS) during transseptal puncture. TT, TE and IC echoCG were carried out in 32, 26, and 150 cases, respectively. Phenomenon of IAS stretching was visualized by TT echoCG in 2 (6%) cases (sensitivity 6.7%). At TE tenting phenomenon was verified in 20 patients (20%) (sensitivity 86.9%). Puncture of IAS was carried out under IC echoCG control in 127 patients. Puncture was made in the center of thin portion of IAS (in the region of fossa ovalis), in its upper and lower portions in 65, 28, and 15.7% of cases, respectively. Sensitivity of IC echoCG was 98.4%. Rate of false positive results reached 92.8, 13.04 and 1.5% for TT, TE and IC echoCG, respectively. At present IC echoCG is most sensitive and safe ultrasound technique for verification of optimal positioning of the system for conduct of transseptal puncture in the region of IAS in comparison with TT and TE echoCG.
Subject(s)
Catheter Ablation/methods , Echocardiography/methods , Heart Atria/diagnostic imaging , Heart Conduction System/surgery , Heart Septum/surgery , Monitoring, Intraoperative/standards , Echocardiography, Transesophageal/methods , Endosonography/methods , Female , Follow-Up Studies , Heart Atria/surgery , Humans , Male , Middle Aged , Punctures , Retrospective Studies , Sensitivity and Specificity , Treatment OutcomeABSTRACT
PURPOSE: To estimate echocardiographic measurements in patients with idiopathic ventricular arrhythmias originating from right ventricular outflow tract (RVOT) before and one year after radiofrequency ablation (RFA) comparing with healthy volunteers. MATERIALS AND METHODS: The study consisted of 30 patients (7 women, 34.9+/-15.2 years of age) with predominantly repetitive monomorphic ventricular ectopy and nonsustained ventricular tachycardias. Arrhythmia history was 4.6+/-3.5 years. The control group consisted of 20 healthy unselected subjects (5 women, 41.9+/-5.3 years of age) without left ventricular (LV) dysfunction. All consecutive patients with idiopathic ventricular arrhythmias underwent electrophysiology study and RFA. Transthoracic echocardiography was performed before, 2, 6 and 12 months after RFA. RESULTS: Significantly higher LV end diastolic volume and lower LV ejection fraction were observed in study group patients to compare with control group patients. LV function significantly improved in postablative patients during 1 year follow up. There were no found complications associated with RFA. CONCLUSIONS: Idiopathic ventricular arrhythmias originating from right ventricular outflow tract (RVOT) could be a cause of arrhythmogenic LV remodeling. Successful ablation of the focal source of right ventricular ectopy resulted in normalization of LV function during follow up period.
