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Background Anatomy assessment using Computer Tomography (CT) and Magnetic Resonance (MRI) is performed in patients undergoing pulmonary vein isolation (PVI). The aim of this analysis was to investigate whether electroanatomical 3D map and CT/MRI image integration using the CartoMerge system improves efficacy, reduces procedure time or fluoroscopy usage. Materials and methods 57 patients undergoing PVI were divided in two groups: “Merge” (n=45 pts) and “non-Merge” (n=14 pts) depending on usage of image integration. PV isolation during procedure (acute PVI), procedure time, fluoroscopy time, number of radio frequency (RF) applications and AF recurrence during follow-up (Merge group: 12-24 months, non-Merge group: 9-18 months) were analyzed. Results Intra-procedural PVI was equal in both groups (93%). Long-term efficacy, defined as absence of AF recurrence, was insignificantly higher in the Merge group (69,8% vs 50%, p=0,11793). Procedure time was significantly longer in the Merge group – 239,1 (±55,5) min. vs 192,4 (±44,5). Fluoroscopy time was similar in both groups 29,9 (±12,23) vs 24,6 (±26,5) min, (p=0,579). Number of RF applications was significantly higher in the Merge group 48,5 (±25,2) vs 27,2 (±14,9). Conclusions CartoMerge did not improve the rate of acute PVI, long-term effectivity or fluoroscopy time. In the non-Merge group the procedure time was shorter and the number of applications was significantly smaller.
EN
Background: Anatomy assessment using Computer Tomography (CT) and Magnetic Resonance (MRI) is performed in patients undergoing pulmonary vein isolation (PVI). The aim of this analysis was to investigate whether electroanatomical 3D map and CT/MRI image integration using the CartoMerge system improves efficacy, reduces procedure time or fluoroscopy usage. Materials and methods: 57 patients undergoing PVI were divided in two groups: “Merge” (n=45 pts) and “non-Merge” (n=14 pts) depending on usage of image integration. PV isolation during procedure (acute PVI), procedure time, fluoroscopy time, number of radio frequency (RF) applications and AF recurrence during follow-up (Merge group: 12-24 months, non-Merge group: 9-18 months) were analyzed. Results: Intra-procedural PVI was equal in both groups (93%). Long-term efficacy, defined as absence of AF recurrence, was insignificantly higher in the Merge group (69,8% vs 50%, p=0,11793). Procedure time was significantly longer in the Merge group – 239,1 (±55,5) min. vs 192,4 (±44,5). Fluoroscopy time was similar in both groups 29,9 (±12,23) vs 24,6 (±26,5) min, (p=0,579). Number of RF applications was significantly higher in the Merge group 48,5 (±25,2) vs 27,2 (±14,9). Conclusions: CartoMerge did not improve the rate of acute PVI, long-term effectivity or fluoroscopy time. In the non-Merge group the procedure time was shorter and the number of applications was significantly smaller.
EN
Background: Our aim was to determine if there is a difference in demand for analgesic and sedative medication according to the type of catheter ablation for atrial fibrillation (AF). Material and methods: We collected data from protocols of 1144pts, who underwent ablation of AF. We excluded 275pts, at most due to electrocardioversion during the procedure. We divided them into 4 groups: cryoballoon ablation group (CB, n = 101), single-point radiofrequency ablation group (RFth-, n = 541), single-point radiofrequency ablation group with thermocool catheter (RFth+, n = 156) and Multielectrode Pulmonary Vein Ablation Catheter group (PVAC, n = 71). We used fentanyl and midazolam for pain control. The dose was adjusted by the operator, accord-ing to patients’ request. Results: The median dose of fentanyl 0.04 mg (0.00-0.08) and midazolam 1.00 mg (0.00-2.00) in CB group was lower than in other groups (p < 0.001). The median dose of fentanyl 0.12 mg (0.08-0.17) was lower in RFth- than in in RFth+ group: 0.15 mg (0.1-0.2) (p < 0.001). The demand for analgesia was higher when PVAC was used, with median dose of fentanyl 0.15 mg (0.1-0.2) (p < 0.0024). Conclusions: The demand for analgesic/sedative medication was lower among patients who underwent CB. Among those who underwent RF ablation it was higher in groups with thermocool and multielectrode catheters.
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