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Impact of Systematic Use of Intracardiac Ultrasound during Transseptal Catheterization in the Electrophysiology Laboratory

Aims: To explore the impact of the use of intracardiac echocardiography (ICE) in the ablation of supraventricular arrhythmias requiring transseptal catheterization (TSC), whilst analyzing the reduction in periprocedural complications and complications specifically related to TSC. Methods: A retrospe...

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Autores principales: Bottoni, Nicola, Donateo, Paolo, Rossi, Luca, Malagù, Michele, Tomasi, Luca, Quartieri, Fabio, Biagi, Andrea, Iori, Matteo, Mugnai, Giacomo, Battista, Antonella, Cló, Stefano, Brignole, Michele, Bertini, Matteo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9960297/
https://www.ncbi.nlm.nih.gov/pubmed/36826558
http://dx.doi.org/10.3390/jcdd10020062
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author Bottoni, Nicola
Donateo, Paolo
Rossi, Luca
Malagù, Michele
Tomasi, Luca
Quartieri, Fabio
Biagi, Andrea
Iori, Matteo
Mugnai, Giacomo
Battista, Antonella
Cló, Stefano
Brignole, Michele
Bertini, Matteo
author_facet Bottoni, Nicola
Donateo, Paolo
Rossi, Luca
Malagù, Michele
Tomasi, Luca
Quartieri, Fabio
Biagi, Andrea
Iori, Matteo
Mugnai, Giacomo
Battista, Antonella
Cló, Stefano
Brignole, Michele
Bertini, Matteo
author_sort Bottoni, Nicola
collection PubMed
description Aims: To explore the impact of the use of intracardiac echocardiography (ICE) in the ablation of supraventricular arrhythmias requiring transseptal catheterization (TSC), whilst analyzing the reduction in periprocedural complications and complications specifically related to TSC. Methods: A retrospective multicenter study collecting data from consecutive atrial fibrillation (AF) and supraventricular ablation procedures that required TSC was performed in five Italian centers. Based on physician discretion, TSC was performed with or without ICE. Periprocedural complications, separating all complications from complications directly related to TSC, were collected. Independent predictors of periprocedural complications and TSC-related complications were investigated. Results: A total of 2181 TSCs were performed on 1862 patients at five Italian centers from 2006 to 2021, in 76% of cases by AF ablation and in 24% by ablation of other arrhythmias with a circuit in the left atrium. Overall, 1134 (52%) procedures were performed with ICE support and 1047 (48%) without ICE. A total of 67 (3.1%) complications were detected, 19 (1.7%) in the ICE group and 48 (4.6%) in the no ICE group, p < 0.001. A total of 42 (1.5%) complications directly related to TSC: 0.9% in the ICE group and 3.1% in the no ICE group (p < 0.001). The independent predictors of all complications were age (OR 1,02 95% C.I 1.00–1.05; p = 0.036), TSC with the use of ICE (OR 0.27 95% C.I 0.15–0.46; p < 0.001) and AF ablation (OR 2,25 95%C.I 1.05–4.83; p = 0.037). The independent predictors for TSC complications were age (OR 1.03 95% C.I 1.01–1.06; p = 0.013) and TSC with the use of ICE (OR 0.24 95% C.I 0.11–0.49; p < 0.001). Conclusions: ICE reduced periprocedural and TSC-related complications during electrophysiological procedures for ablation of left atrial arrhythmias.
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spelling pubmed-99602972023-02-26 Impact of Systematic Use of Intracardiac Ultrasound during Transseptal Catheterization in the Electrophysiology Laboratory Bottoni, Nicola Donateo, Paolo Rossi, Luca Malagù, Michele Tomasi, Luca Quartieri, Fabio Biagi, Andrea Iori, Matteo Mugnai, Giacomo Battista, Antonella Cló, Stefano Brignole, Michele Bertini, Matteo J Cardiovasc Dev Dis Article Aims: To explore the impact of the use of intracardiac echocardiography (ICE) in the ablation of supraventricular arrhythmias requiring transseptal catheterization (TSC), whilst analyzing the reduction in periprocedural complications and complications specifically related to TSC. Methods: A retrospective multicenter study collecting data from consecutive atrial fibrillation (AF) and supraventricular ablation procedures that required TSC was performed in five Italian centers. Based on physician discretion, TSC was performed with or without ICE. Periprocedural complications, separating all complications from complications directly related to TSC, were collected. Independent predictors of periprocedural complications and TSC-related complications were investigated. Results: A total of 2181 TSCs were performed on 1862 patients at five Italian centers from 2006 to 2021, in 76% of cases by AF ablation and in 24% by ablation of other arrhythmias with a circuit in the left atrium. Overall, 1134 (52%) procedures were performed with ICE support and 1047 (48%) without ICE. A total of 67 (3.1%) complications were detected, 19 (1.7%) in the ICE group and 48 (4.6%) in the no ICE group, p < 0.001. A total of 42 (1.5%) complications directly related to TSC: 0.9% in the ICE group and 3.1% in the no ICE group (p < 0.001). The independent predictors of all complications were age (OR 1,02 95% C.I 1.00–1.05; p = 0.036), TSC with the use of ICE (OR 0.27 95% C.I 0.15–0.46; p < 0.001) and AF ablation (OR 2,25 95%C.I 1.05–4.83; p = 0.037). The independent predictors for TSC complications were age (OR 1.03 95% C.I 1.01–1.06; p = 0.013) and TSC with the use of ICE (OR 0.24 95% C.I 0.11–0.49; p < 0.001). Conclusions: ICE reduced periprocedural and TSC-related complications during electrophysiological procedures for ablation of left atrial arrhythmias. MDPI 2023-02-02 /pmc/articles/PMC9960297/ /pubmed/36826558 http://dx.doi.org/10.3390/jcdd10020062 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bottoni, Nicola
Donateo, Paolo
Rossi, Luca
Malagù, Michele
Tomasi, Luca
Quartieri, Fabio
Biagi, Andrea
Iori, Matteo
Mugnai, Giacomo
Battista, Antonella
Cló, Stefano
Brignole, Michele
Bertini, Matteo
Impact of Systematic Use of Intracardiac Ultrasound during Transseptal Catheterization in the Electrophysiology Laboratory
title Impact of Systematic Use of Intracardiac Ultrasound during Transseptal Catheterization in the Electrophysiology Laboratory
title_full Impact of Systematic Use of Intracardiac Ultrasound during Transseptal Catheterization in the Electrophysiology Laboratory
title_fullStr Impact of Systematic Use of Intracardiac Ultrasound during Transseptal Catheterization in the Electrophysiology Laboratory
title_full_unstemmed Impact of Systematic Use of Intracardiac Ultrasound during Transseptal Catheterization in the Electrophysiology Laboratory
title_short Impact of Systematic Use of Intracardiac Ultrasound during Transseptal Catheterization in the Electrophysiology Laboratory
title_sort impact of systematic use of intracardiac ultrasound during transseptal catheterization in the electrophysiology laboratory
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9960297/
https://www.ncbi.nlm.nih.gov/pubmed/36826558
http://dx.doi.org/10.3390/jcdd10020062
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