Kardiális nekrózis-marker kiáramlás és zero fluoroszkópiás technika vizsgálata pitvari ritmuszavarok ablációjában
Tahin Tamás
Theoretical and Translational Medicine
Dr. Kellermayer Miklós
SE Városmajori Szív- és Érgyógyászati Klinika
2025-02-03 10:00:00
Cardiovascular Disorders: Physiology and Medicine of Ischaemic Circulatory Diseases
Dr. Merkely Béla
Dr. Gellér László
Dr. Kardos Attila
Demeterné Dr. Kiss Orsolya
Dr. Székely Andrea
Dr. Boros András Mihály
Dr. Clemens Marcell
In our first, prospective study we compared the long-term changes of specific necroenzymes, hsTnT and CKMB during catheter ablation of EFV and AVNRT, PFlu and PF. While CKMB levels did not, hsTnT concentrations changed significantly after EFV and RF ablation. The mean hsTnT level showed a positive correlation with the ablation time. The highest mean hsTnT concentration was observed after PF ablation, which remained positive in half of the patients 3 months after the ablation. Considering the observations described above is essential for a proper interpretation of the hsTnT level after RF ablation. Based on our studies, knowing the hsTnT level after ablation can be helpful mainly in the case of differential diagnosis problems, in the case of the co-existence of chest pain and ECG changes occurring after ablation, to differentiate between myocardial infarction and acute coronary syndrome.
Our second study we have proven that, with the help of currently available tools and methods, ZF PVI can be performed safely and that neither the time of the examination increases significantly, nor the acute and long-term success rate is lower.
According to our first, limited experience, redo PF ablation procedures can also be successfully performed with this new technique.
Due to the low number of complications occurring in the "de novo" ablation groups, it is recommended to interpret the results with reservations. Because the number of patients was relatively small, this limits the interpretation of safety conclusions. The overall 1-year success rate of PVI may seem lower than in some recently published studies, however, some technologies (including ablation index-guided technique or high-power, short duration ablation technique) were not available in our laboratory at the time the study was conducted.
Although absorbed dose is an important parameter, it was not collected in this study and only fluoroscopy times are reported. Fluoroscopy times correlate much more with the technique used than with the radiation dose, which is influenced by the parameters of the patient's body. Further, larger-scale studies are needed to confirm our initial observations.
