fluoroscopic time
Recently Published Documents


TOTAL DOCUMENTS

61
(FIVE YEARS 22)

H-INDEX

8
(FIVE YEARS 1)

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Raluca Sirbu Prisecaru ◽  
Cristina Leatu ◽  
Leila Riahi ◽  
Victor Costache

Abstract Purpose To compare the predictive accuracy of five different algorithms as verified by successful ablation site using 3D electroanatomical non-contact mapping in patients with symptomatic and asymptomatic but high ventricular burden RVOT tachycardias. Methods 28 Consecutive patients admitted for radiofrequency catheter ablation for symptomatic and asymptomatic, but high ventricular burden idiopathic VPC were recruited for this study. All patients had previous failed or intolerant to beta-blocker and/or at least one class IC anti-arrhythmic agents, and they had normal left ventricular ejection fraction. All patients had documented monomorphic VPC with left bundle branch block morphology and an inferior axis. Concordance of the arrhythmia origin based on ECG algorithm and 3D mapping system site were further evaluated. Of the five algorithms, two algorithms with easy‐applicability and having a memorable design (Dixit and Joshi) and three algorithms with more complex and detailed design (Ito, Zhang, Pytkowski) were selected for comparisons. Results Assessment of the diagnostic accuracy showed that each of the five algorithms had only moderate accuracy, and the greatest accuracy was observed in the algorithm proposed by Pytkowski algorithm when assessed by a general cardiologist and Dixit algorithm when evaluated by the electrophysiologist. However, when the algorithms were compared for their accuracy, specificity, sensitivity, no significant differences were found (p = 0.99). Conclusions The ECG based algorithms for precise localising RVOTA origin simplify the mapping process, reduce the procedural and fluoroscopic time, and improve clinical outcomes, resulting in greater clinical utility. All the five published 12-lead ECG algorithms for ROTVA differentiation were similar in terms of the diagnostic accuracy, specificity, sensitivity and LRs.


2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Maria Sanfilippo ◽  
Giampiero Vizzari ◽  
Giuseppe Giacchi ◽  
Nastasia Mancini ◽  
Marta Allegra ◽  
...  

Abstract Aims Left atrial appendage closure (LAAC) is usually performed under general anesthesia to allow prolonged transesophageal echocardiography (TEE) guidance. There is scarce knowledge about the feasibility and safety of moderate conscious sedation (MCS) in LAAC. We aimed to assess the feasibility, effectiveness and safety of an innovative MCS protocol of dexmedetomidine plus midazolam (MID-DEX), in a retrospective population of LAAC patients. Methods and results A total of 100 patients underwent LAAC with MCS using the MID-DEX protocol between May 2019 and January 2021 in a single centre. Clinical and procedural outcomes of these patients have been collected in the context of a retrospective registry on LAAC with the Watchman FLX device. All patients were treated preoperative with Dex, administered with initial bolus infusion (1.0 mcg/kg) in 10 min, then i.v. infusion was maintained throughout the LAAC procedure (0.2–1.0 μg/kg/h), tailored on patient’s frailty (advanced age, low body mass index) and haemodynamic status (BP, HR). Midazolam was administered to patients after Dex bolus, to induce sedation and to ease probe insertion, according to patient age and respiratory status (from 2.5 to max 10 mg). The ease of insertion of the TEE probe (one very easy—five impossible), and the duration of the TEE (m′) were recorded. Additional variables were: total amount of each drug given, time to recovery from sedation. After procedure a verbal survey about the quality of sedation, level of comfort, recall of the procedure, and future acceptance of this type of sedation was administered. The operators also rated the procedural conditions on a scale of 1–5 (5 = excellent). Mean patient age was 78.5 ± 6.96 years and 34% were women. The mean LVEF was 62.9 ± 8.9%. All patients underwent LAAC under MID-DEX MCS protocol with an acute procedural success rate of 100%. Ninety patients (90%) successfully underwent TEE under MCS; in 10 patients ICE guidance was required. Fluoroscopic time was 31 ± 21.7 min. The median required dosage of Dex infusion was 0.08–0.09 μg/kg/h and midazolam was 6.2 ± 2.4 mg. No complications were observed from MCS. There was no need for conversion to GA during the procedure. We observed five cases of bradycardia (solved by reducing to half Dex infusion) and three of hypotension (only two requiring Ringer’s solution infusion). Echocardiographist rated procedural conditions as perfect (5) in 85% of cases and good (4) in 6%. Interventionalist rated procedural comfort with 5 (excellent) in 90% of cases and 4 (good) in 3%. Patients satisfaction was high with best rate (5) in 80% with 5% of 4 (good); 12% described the procedure as fair, without memory of discomfort. Conclusions LAAC is safe and effective when performed under MCS. Thus, applying MCS may simplify the LAAC procedure, as well as reduce procedural time and procedural costs, while increasing overall patient and physician satisfaction.


2021 ◽  
Vol 42 (2) ◽  
pp. 154-159
Author(s):  
Somboon Phaijitwichian ◽  

Objective: The aim of this study was to compare the efficacy, access tract dilation time and fluoroscopic time between the one-shot dilation technique and telescopic metal dilatation technique in patients undergoing percutaneous nephrolithotomy in Nakornping Hospital. Materials and Methods: Sixty-six patients who underwent percutaneous nephrolithotomy from January 2020 to July 2021 were included in the study and they were randomly divided into two groups. In group 1 (32 patients), telescopic metal dilation was used, in group 2 (33 patients), the one-shot technique was used. Success rates of dilation, access tract dilation time and fluoroscopic time were evaluated. Results: The success rate of dilation was 100% in both groups. The access tract dilation time was 835.63 ± 309.68 seconds in group 1 and 569.42 ± 314.75 seconds in group 2 (p = 0.001). The fluoroscopic time was 48.16 ± 22.16 seconds in group 1 and 41.97 ± 23.99 seconds in group 2 (p = 0.29). The access tract dilation time of the one-shot dilation technique was statistically significantly shorter than that in the telescopic metal dilatation group. The mean fluoroscopic time of the one- shot dilation technique was shorter than in telescopic metal dilatation but was not statistically significant. Conclusion: One-shot dilation technique is as effective as telescopic metal dilatation, with a significant reduction in access tract dilation time.


Author(s):  
Xinhua Li ◽  
Joshua Adam Hirsch ◽  
Madan M. Rehani ◽  
Kai Yang ◽  
Theodore Alan Marschall ◽  
...  

Objectives: To present the median value and 75th percentile of air kerma at the reference point (Ka,r), air kerma-area product (KAP), and fluoroscopic time for a large number of fluoroscopically-guided interventional (FGI) procedures. Methods: This retrospective study included the consecutive non-coronary FGI procedures from a Radiology department between May 2016 and October 2018 at a large tertiary care hospital in the U.S. An in-house developed, semi-automated software, integrated with a dictation system, was used to record patient examination information, including Ka,r, KAP and fluoroscopic time. The included patient procedures were categorized into procedure types. A software package R (version 3.5.1, R Foundation) was used to calculate procedure-specific quartiles of radiation exposure. Results: Based on analysis of 24,911 FGI cases, median value and 75th percentile are presented for each of Ka,r, KAP and fluoroscopic time for 101 procedures that can act as benchmark for comparison for dose optimization studies. Conclusion: This study provides reference levels (50th and 75th percentiles) for a comprehensive list of FGI procedures, reflecting an overall picture of the latest FGI studies for diagnosis, targeted minimally invasive intervention, and therapeutic treatment. Advances in knowledge: This study provides reference levels (50th and 75th percentiles) for the largest number of fluoroscopically-guided interventional procedures reported to-date (101 procedures), in terms of air kerma at the reference point, air kerma-area product, and fluoroscopic time, among which these quartiles for ≥50 procedures are presented for the first time.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C Arellano Serrano ◽  
J.F Oteo Dominguez ◽  
A Garcia Touchard ◽  
J.A Fernandez Diaz ◽  
M Del Trigo Espinosa ◽  
...  

Abstract Introduction Cardiac Allograft Vasculopathy (CAV) and Acute Rejection (AR) surveillance after a Heart Transplant (HT) is based on the performance of Coronary Angiography (CAG) that requires arterial access and Endomyocardial Biopsy, normally Ventricular Right (RV-EMB), which requires venous access. Depending on the clinical indication, HT patients are referred to the cath lab to perform both procedures in the same day. We evaluated the effectiveness and safety of performing a Left Ventricular Endomyocardial Biopsy (LV-EMB) and a CAG with a single artery access. Methods We retrospectively analyzed HT patients referred to cath lab for surveillance of AR and CAV on the same day between January 2018 and March 2021. We compared the procedures performed with two accesses (Group 1; CAG + RV-EMB) versus procedures made with a single artery access (Group 2; CAG + LV-EMB). Results 121 Procedures were performed within the indicated period, 96 (79.3%) belong to the double access group and 25 (20.7%) to the single access group. All procedures were successful and without major complications. There were only 2 cases of insufficient sample, one for each group. Baseline characteristics in both groups and AR or CAV presence were similar (table). Total procedure time (52.00±15.30 vs 33.36±18.69min) and fluoroscopic time (10.70±4.89 vs 6.84±1.82 min) were significantly shorter in the single access group (p<0.001 in both). The most used arterial access in group 2 was the right radial artery (15; 60%) followed by the right femoral artery (5; 20%). Conclusions Performing an endomyocardial biopsy and coronary angiography through a single arterial access is as effective and safe as with double access, arterial and additional venous. Procedure time and fluoroscopic time is significantly less when it is performed through the same access. FUNDunding Acknowledgement Type of funding sources: None.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed E. Abo Ghareeb ◽  
Mohamed H Elsaid ◽  
Abdelrahman A Abdallah

Abstract Corresponding Background Stone size is a key factor in the determination of the success of author: treatment modalities. Recently, there has been a great advancement in technology for minimally invasive management of urinary stones such as percutaneous nephrolithotomy, ureteroscopy, shockwave lithotripsy, and retrograde internal Surgery Aim of the Work to compare the outcome of PCNL and RIRS in medium sized renal pelvic stoned in adults regarding operative time, fluoroscopic time, intra and postoperative complications, stone free rate, hospital stay and postoperative stenting. Patients and Methods This prospective randomized clinical study was conducted on 30 patients from April 2019 to January 2020, all patients had single renal pelvic stone (10 to 20 mm) and had no contraindication to perform these operations at the Urology department, Ain Shams University Hospitals and National Institute of Urology and Nephrology. The patients were randomized by (1 : 1) manner for either PCNL or RIRS. All preoperative, intraoperative and postoperative parameters, results and complications between both groups were recorded. Results Mean fluoroscopic time and hospital stay were significantly greater in PCNL group than RIRS group. The stone free rate was 86.7% (13/15) in PCNL group and 80% (12/15) in RIRS group and for complications (according to Cliven-Dindo score) there were no statistically significant difference between two groups.Complications occurred in 3(20%) patients in PCNL group and in 2(13.3%) patients in RIRS group. PCNL and RIRS are safe and effective methods for medium sized renal pelvic stones. For selected patients, RIRS may represent an alternative therapy to PCNL, with acceptable efficacy and low morbidity. RIRS compared to PCNL offers the best outcome in terms of radiation exposure and hospital stay. Conclusion RIRS may represent an alternative therapy to PCNL, RIRS compared to PCNL offers the best outcome regarding radiation exposure and hospital stay.


2021 ◽  
Vol 8 ◽  
Author(s):  
Wei-Chieh Lee ◽  
Po-Jui Wu ◽  
Huang-Chung Chen ◽  
Hsiu-Yu Fang ◽  
Ping-Yen Liu ◽  
...  

Background: Age affects the efficacy of pharmacological treatment for atrial fibrillation (AF). Catheter ablation, including radiofrequency (RF) or cryoballoon ablation, is an effective strategy for symptomatic AF. This meta-analysis aimed to analyze the efficacy and safety of AF ablation in elderly patients with AF compared to non-elderly patients with AF.Methods: We searched several databases for articles published between January 1, 2008 and March 31, 2020. Eighteen observational studies with 21,039 patients were analyzed. Data including recurrence of AF or atrial tachyarrhythmia (ATA), complications, procedural time, and fluoroscopic time were compared between the elderly and non-elderly groups.Results: The elderly patients had significantly higher incidences of recurrent AF or ATA after AF ablation compared to the non-elderly patients (<60 years old) (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.11–1.33). The elderly patients had significantly higher incidences of complications of AF ablation compared to the non-elderly patients (OR, 1.37; 95% CI, 1.14–1.64). However, elderly AF patients with age ≥75 years old had similar incidence of recurrent AF or ATA and complication after AF ablation compared to non-elderly patients with AF.Conclusions: The elderly patients had significantly higher incidences of recurrent AF or ATA and complications after ablation for non-paroxysmal AF compared to non-elderly patients with AF (<60 years old), except in patients ≥75 years old.


2021 ◽  
Vol 8 ◽  
Author(s):  
Wei Hua ◽  
Xi Liu ◽  
Min Gu ◽  
Hong-xia Niu ◽  
Xuhua Chen ◽  
...  

Introduction: His bundle pacing (HBP) is the most widely used physiological pacing modality, but difficulties in locating the His bundle lead to high fluoroscopic exposure. An electroanatomical mapping (EAM) system can be an efficient tool to achieve HBP implantation with near-zero fluoroscopic visualization.Methods: In the study, 20 patients who had indications for pacemaker implantation were prospectively enrolled and underwent HBP implantation either with the conventional fluoroscopy approach (the standard group) or guided by a novel KODEX-EPD mapping system (the EAM-guided group). The success rate, procedural details, pacing parameters, and procedure-related complications were compared between the two groups.Results: In the study, 20 consecutive patients were randomized with 10 patients in each group. HBP was successfully achieved in nine patients in the standard group and nine patients in the EAM-guided group. The procedural time was similar between the EAM-guided group vs. the standard group (85.40 ± 22.34 vs. 86.50 ± 15.05 min, p = 0.90). In comparison with the standard group, the EAM-guided group had a significant shorter total fluoroscopic time (FT) (1.45 ± 0.58 vs. 12.36 ± 5.46 min, p < 0.01) and His lead fluoroscopic time (HL-FT) (0.84 ± 0.56 vs. 9.27 ± 5.44 min, p < 0.01), while lower total fluoroscopic dose (3.13 ± 1.24 vs. 25.38 ± 11.15 mGy, p < 0.01) and His lead fluoroscopic dose (1.85 ± 1.17 vs. 19.06 ± 11.03 mGy, p < 0.01). No significant differences were observed in paced QRS duration and pacing parameters between the two groups. During a 3-month follow-up, one patient had a capture threshold increased >1 V/1.0 ms in the standard group, while no other complications were recorded in either group.Conclusion: The KODEX-EPD system could facilitate HBP implantation with significantly reduced FT and dose without compromising the procedural time.


2021 ◽  
Vol 8 ◽  
Author(s):  
Zhongyuan Ren ◽  
Binni Cai ◽  
Songyun Wang ◽  
Peng Jia ◽  
Yang Chen ◽  
...  

Background: Left bundle branch pacing (LBBP) has been shown to be a safe and effective means to achieve physiological pacing. However, elderly patients have increased risks from invasive procedures and the risk of LBBP in elderly patients is not known. We aimed to investigate the safety and efficacy of LBBP in elderly patients >80 years of age.Methods: From December 2017 to June 2019, 346 consecutive patients with symptomatic bradycardia, 184 patients under 80 years of age and 162 over 80 years, were included and underwent LBBP. The safety and prognosis of LBBP were comparatively evaluated by measured pacing parameters, periprocedural complications, and follow-up clinical events.Results: Compared with the younger, the elderly group had worse baseline cardiac and renal function. LBBP was achieved successfully in both groups with comparable fluoroscopic time and paced QRS duration (110.0 [102.0, 118.0] ms for the young vs. 110.0 [100.0, 120.0] ms for the elderly, P = 0.874). Through a follow-up of 20.0 ± 6.1 months, pacing parameters were stable while higher threshold and impedance were observed in the elderly group. In the evaluation of safety, overall procedure-related complication rates were comparable (4.4 vs. 3.8%, young vs. elderly). For prognosis, similar rates of major adverse cardiocerebrovascular events (7.1 vs. 11.9%, young vs. elderly) were observed.Conclusions: Compared to younger patients, LBBP could achieve physiological pacing in patients over 80 with comparable midterm safety and prognosis. Long-term safety and benefits of LBBP, however, necessitate further evaluation.


Sign in / Sign up

Export Citation Format

Share Document