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Intracardiac Versus Transesophageal Echocardiography Versus Fluoroscopy Only Guidance for Combined Catheter Ablation for Atrial Fibrillation and Left Atrial Appendage Occlusion

Not Applicable
Completed
Conditions
Atrial Fibrillation
Interventions
Procedure: LAAC combined with radiofrequency ablation
Registration Number
NCT04833985
Lead Sponsor
xieruiqin
Brief Summary

A total of 75 patients with atrial fibrillation were scheduled to receive left atrial appendage occlusion combined with radiofrequency ablation, which were divided into 3 groups. The operation was performed under the guidance of intracardiac echocardiography and transesophageal echocardiography and fluoroscope only respectively (allocation ratio 1:1:1). During the operation, the total amount of contrast medium injected, the fluoroscopy time and the time from femoral vein puncture to transseptal puncture to closure were recorded in all patients. All patients underwent transesophageal echocardiography before and 3 months after operation, and the results were explained by two experienced ultrasound doctors to measure the presence of left atrial thrombus, residual shunt and device-related thrombus. All patients were examined by transthoracic echocardiography 3 months after operation to evaluate new pericardial effusion, pericardial tamponade, instrument embolization / displacement and so on. The baseline clinical and surgical features and hospitalization outcomes of patients guided by ICE and TEE and fluoroscopy only were recorded and compared. Clinical endpoints include death, new pericardial effusion that does not require pericardiocentesis, tamponade with pericardiocentesis, instrument embolism / displacement, bleeding at the entry site, thromboembolic events (stroke / transient ischemic attack \[TIA\]). The purpose of this study was to evaluate the feasibility, safety and effectiveness of intracardiac echocardiographic (ICE)-guided and transesophageal echocardiographic (TEE)-guided and fluoroscopy only-guided left atrial appendage occlusion combined with radiofrequency ablation. The average follow-up time is 3 months.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
75
Inclusion Criteria

AF attack occurred in patients with a duration of more than one year, patients taking class I and class III antiarrhythmic drugs could not prevent AF, patients younger than 80 years old Cha2ds2-vasc score ≥2 and HAS-BLED score ≥3, not suitable for long-term oral anticoagulant drugs.

Exclusion Criteria

Patients with a history of atrial thrombosis or valvular heart disease (moderate or severe valve stenosis or severe valve regurgitation), patients undergoing prosthetic heart valve replacement, pregnant women, patients with previous liver and kidney diseases, malignant tumors or blood system diseases.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
intracardiac echocardiography guidanceLAAC combined with radiofrequency ablation-
transesophageal echocardiography guidanceLAAC combined with radiofrequency ablation-
fluoroscopy only guidanceLAAC combined with radiofrequency ablation-
Primary Outcome Measures
NameTimeMethod
fluoroscopy time were recordedin the procedure

mGy

injected contrast mediain the procedure

milliliter

Secondary Outcome Measures
NameTimeMethod
the size of the selected umbrella in operationin the procedure

millimeter

residual shunt and DRT after transcatheter closure of left atrial appendage detectedbefore operation and 3 months after operation

Transesophageal echocardiography

pericardial tamponade were detected3 months after operation

Transthoracic echocardiography

the time from femoral vein puncture to transseptal puncture to closure were recordedin the procedure

second

The size of the LAAin the procedure

millimeter

new pericardial effusion were detected3 months after operation

Transthoracic echocardiography

Trial Locations

Locations (1)

Second Hospital of Hebei Medical University

🇨🇳

Shijiazhuang, Hebei, China

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