Abstract：
OBJECTIVE: Catheter ablations of complex cardiac arrhythmias are currently guided by electro-anatomic mapping systems. The aim of this study was to compare two different approaches: remotely supported nurse-led electro-anatomic mapping with standard onsite engineer support.
RESULTS: In this retrospective observational study, 166 patients with complex and non-complex procedures were included. 82 patients benefited from electro-anatomic mapping with remotely supported nurse-led mapping (mean age: 62±16years), while the approach for 84 patients was with standard onsite engineer support (mean age: 56±19 years). Procedural characteristics, acute results and complication rates were compared between both groups and showed similar results.Complex and non-complex procedures were conducted in both groups, including left atrial and ventricular procedures. As ventricular tachycardia and accessory pathway ablations were more frequently conducted with standard onsite engineer support, we separately analyzed the largest subgroup, 105 patients with atrial fibrillation, left atrial flutter and left atrial tachycardia. Patients in this subgroup had comparable baseline characteristics, procedure times and procedural success. Nevertheless, there were longer ablation times and more utilization of fluoroscopy in the onsite group, most likely due to more complex procedures.
CONCLUSIONS: Our results underline the practicality of remotely supported nurse-led electro-anatomic mapping. The latter approach proved to be a safe alternative to onsite engineer support. Due to its advantages, particularly for insular settings, it will likely play a greater role in the future.
RESULTS: In this retrospective observational study, 166 patients with complex and non-complex procedures were included. 82 patients benefited from electro-anatomic mapping with remotely supported nurse-led mapping (mean age: 62±16years), while the approach for 84 patients was with standard onsite engineer support (mean age: 56±19 years). Procedural characteristics, acute results and complication rates were compared between both groups and showed similar results.Complex and non-complex procedures were conducted in both groups, including left atrial and ventricular procedures. As ventricular tachycardia and accessory pathway ablations were more frequently conducted with standard onsite engineer support, we separately analyzed the largest subgroup, 105 patients with atrial fibrillation, left atrial flutter and left atrial tachycardia. Patients in this subgroup had comparable baseline characteristics, procedure times and procedural success. Nevertheless, there were longer ablation times and more utilization of fluoroscopy in the onsite group, most likely due to more complex procedures.
CONCLUSIONS: Our results underline the practicality of remotely supported nurse-led electro-anatomic mapping. The latter approach proved to be a safe alternative to onsite engineer support. Due to its advantages, particularly for insular settings, it will likely play a greater role in the future.
摘要：
目的：复杂心律失常的导管消融目前是由电解剖标测系统引导的。这项研究的目的是比较两种不同的方法：远程支持的护士主导的电解剖图与标准的现场工程师支持。
结果：在这项回顾性观察研究中，纳入了166例复杂和非复杂手术的患者。82名患者受益于远程支持的护士主导的电子解剖标测（平均年龄：62±16岁），而84例患者的方法是标准的现场工程师支持（平均年龄：56±19岁）。程序特征，比较两组的急性结果和并发症发生率,结果相似.两组都进行了复杂和非复杂的手术，包括左心房和心室手术。由于室性心动过速和旁路消融在标准现场工程师支持下更频繁地进行,我们分别分析了最大的子群，105例房颤患者,左房扑和左房性心动过速。此亚组患者具有相当的基线特征，程序时间和程序成功。然而，在现场组有更长的消融时间和更多的透视使用，很可能是由于更复杂的程序。
结论：我们的结果强调了远程支持的护士主导的电解剖标测的实用性。后一种方法被证明是现场工程师支持的安全替代方法。由于其优点,特别是对于岛屿环境，它可能在未来发挥更大的作用。
结果：在这项回顾性观察研究中，纳入了166例复杂和非复杂手术的患者。82名患者受益于远程支持的护士主导的电子解剖标测（平均年龄：62±16岁），而84例患者的方法是标准的现场工程师支持（平均年龄：56±19岁）。程序特征，比较两组的急性结果和并发症发生率,结果相似.两组都进行了复杂和非复杂的手术，包括左心房和心室手术。由于室性心动过速和旁路消融在标准现场工程师支持下更频繁地进行,我们分别分析了最大的子群，105例房颤患者,左房扑和左房性心动过速。此亚组患者具有相当的基线特征，程序时间和程序成功。然而，在现场组有更长的消融时间和更多的透视使用，很可能是由于更复杂的程序。
结论：我们的结果强调了远程支持的护士主导的电解剖标测的实用性。后一种方法被证明是现场工程师支持的安全替代方法。由于其优点,特别是对于岛屿环境，它可能在未来发挥更大的作用。
