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Abstract：
OBJECTIVE: This study aimed at exploring how using different kinds of sheaths will affect the very first ablation procedure of apprentices.
METHODS: 15 patients with paroxysmal atrial fibrillation were randomized to used fixed-curve, conventional steerable or visualized steerable sheath, and received complete isolation of pulmonary veins. All ablations were the very first procedure performed by 15 ablation apprentices. The use of fluoroscopy and catheter stability during the PVI were analyzed.
RESULTS: Procedure duration was much longer in the fixed-curve group (116.8 ± 27 vs. 62.2 ± 17 vs. 60.4 ± 17, p < 0.001). X-ray exposure was lowest with visualized sheath (17.6 ± 5 vs. 18.6 ± 6 vs. 5.2 ± 6, p < 0.001). CF SD differed significantly, especially at the anterior aspect of LSPV (7.90 ± 2.90 vs. 5.04 ± 2.18 vs. 4.52 ± 2.40, p < 0.001) and posterior aspect of RSPV (6.84 ± 2.79 vs. 3.42 ± 2.04 vs. 3.50 ± 2.30, p < 0.001) in the fixed-curve group. Impedance drop was significantly smaller in the fixed-curve group at the anterior aspect of LSPV (8.74 ± 3.02 vs. 11.49 ± 5.48 vs. 12.57 ± 5.96, p = 0.005).
CONCLUSIONS: Even for the very first ablation procedure of an ablation apprentice, the use of steerable sheaths will significantly reduce the procedure duration and improve the catheter stability, but only visualized steerable sheath can reduce fluoroscopic time.
METHODS: 15 patients with paroxysmal atrial fibrillation were randomized to used fixed-curve, conventional steerable or visualized steerable sheath, and received complete isolation of pulmonary veins. All ablations were the very first procedure performed by 15 ablation apprentices. The use of fluoroscopy and catheter stability during the PVI were analyzed.
RESULTS: Procedure duration was much longer in the fixed-curve group (116.8 ± 27 vs. 62.2 ± 17 vs. 60.4 ± 17, p < 0.001). X-ray exposure was lowest with visualized sheath (17.6 ± 5 vs. 18.6 ± 6 vs. 5.2 ± 6, p < 0.001). CF SD differed significantly, especially at the anterior aspect of LSPV (7.90 ± 2.90 vs. 5.04 ± 2.18 vs. 4.52 ± 2.40, p < 0.001) and posterior aspect of RSPV (6.84 ± 2.79 vs. 3.42 ± 2.04 vs. 3.50 ± 2.30, p < 0.001) in the fixed-curve group. Impedance drop was significantly smaller in the fixed-curve group at the anterior aspect of LSPV (8.74 ± 3.02 vs. 11.49 ± 5.48 vs. 12.57 ± 5.96, p = 0.005).
CONCLUSIONS: Even for the very first ablation procedure of an ablation apprentice, the use of steerable sheaths will significantly reduce the procedure duration and improve the catheter stability, but only visualized steerable sheath can reduce fluoroscopic time.
摘要：
目的：本研究旨在探讨使用不同类型的鞘管会如何影响学徒的首次消融手术。
方法：15例阵发性心房颤动患者随机采用固定曲线，常规可操纵或可视化可操纵护套，并完全隔离肺静脉.所有消融都是由15名消融学徒进行的首次手术。分析了PVI期间透视检查的使用和导管稳定性。
结果：固定曲线组的手术持续时间更长（116.8±27vs.62.2±17vs.60.4±17，p<0.001)。可视化鞘的X射线暴露最低（17.6±5vs.18.6±6vs.5.2±6，p<0.001)。CFSD差异显著，尤其是在LSPV的前部（7.90±2.90vs.5.04±2.18vs.4.52±2.40，p<0.001）和RSPV的后部（6.84±2.79vs.3.42±2.04vs.固定曲线组3.50±2.30，p<0.001）。固定曲线组LSPV前部的阻抗下降明显较小（8.74±3.02vs.11.49±5.48vs.12.57±5.96，p=0.005）。
结论：即使是消融学徒的第一次消融手术，使用可操纵护套将显著缩短手术时间并提高导管稳定性,但只有可视化的可操纵护套才能减少透视时间。
方法：15例阵发性心房颤动患者随机采用固定曲线，常规可操纵或可视化可操纵护套，并完全隔离肺静脉.所有消融都是由15名消融学徒进行的首次手术。分析了PVI期间透视检查的使用和导管稳定性。
结果：固定曲线组的手术持续时间更长（116.8±27vs.62.2±17vs.60.4±17，p<0.001)。可视化鞘的X射线暴露最低（17.6±5vs.18.6±6vs.5.2±6，p<0.001)。CFSD差异显著，尤其是在LSPV的前部（7.90±2.90vs.5.04±2.18vs.4.52±2.40，p<0.001）和RSPV的后部（6.84±2.79vs.3.42±2.04vs.固定曲线组3.50±2.30，p<0.001）。固定曲线组LSPV前部的阻抗下降明显较小（8.74±3.02vs.11.49±5.48vs.12.57±5.96，p=0.005）。
结论：即使是消融学徒的第一次消融手术，使用可操纵护套将显著缩短手术时间并提高导管稳定性,但只有可视化的可操纵护套才能减少透视时间。
