Position paper concerning the competence, performance and environment required in the practice of complex ablation procedures
The introduction of catheter ablation techniques has vastly improved the treatment of cardiac arrhythmias. However, as complex ablations are technically demanding and can cause various complications, they require a high level of expertise to maximize success rates and minimize complication rates. As...
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| Veröffentlicht in: | Archives of cardiovascular diseases 2019-01, Vol.112 (1), p.67-73 |
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| creator | Maury, Philippe Defaye, Pascal Klug, Didier Alonso, Christine Anselme, Frederic Fauchier, Laurent Gandjbakhch, Estelle Gras, Daniel Hermida, Jean-Sylvain Laurent, Gabriel Mansourati, Jacques Marijon, Eloi Sacher, Frederic Taieb, Jérôme Boveda, Serge Piot, Olivier Sadoul, Nicolas |
| description | The introduction of catheter ablation techniques has vastly improved the treatment of cardiac arrhythmias. However, as complex ablations are technically demanding and can cause various complications, they require a high level of expertise to maximize success rates and minimize complication rates. As French recommendations regarding the required technical competence and equipment are not yet available, this position paper has been compiled by the Working Group of Pacing and Electrophysiology of the French Society of Cardiology, detailing the required features of an interventional cardiac electrophysiological centre for complex ablation procedures: (1) sufficient institutional volume; (2) physician training, qualifications and experience; (3) paramedical staff training and attendance; and (4) institutional facilities and technical equipment. The importance of being able to diagnose, monitor and manage complications associated with complex ablations is highlighted. Supplemental hospital-based resources are also discussed, such as anaesthesia, surgical back-up, intensive care, haemodynamic assistance and imaging. Further, the ideal features of an interventional cardiac electrophysiology training centre are considered. Lastly, the need for quality evaluations and national registries for complex ablations is discussed.
L’avènement des techniques d’ablation percutanée par cathéter a révolutionné le traitement des arythmies cardiaques. Cependant, les ablations complexes demandant une maîtrise technique et pouvant être la source de complications, elles nécessitent un haut niveau d’expertise pour optimiser le taux de succès et minimiser le taux de complications. Au vu de l’absence de recommandations françaises disponibles pour établir les compétences techniques requises, ce document de positionnement a été réalisé par le Groupe de travail de stimulation cardiaque et électrophysiologie de la Société française de cardiologie. Il détaille les caractéristiques requises nécessaires à un centre d’électrophysiologie cardiaque interventionnelle pour la réalisation de procédures d’ablation complexes. 1) volume de procédures par centre. 2) formation, qualification et expérience des électrophysiologistes. 3) formation et présence des paramédicaux. 4) installations et équipement technique du centre. L’importance des capacités diagnostiques, de surveillance et de gestion des complications associées aux ablations complexes est soulignée. Les ressources hospitalières supplémentair |
| doi_str_mv | 10.1016/j.acvd.2018.05.006 |
| format | Article |
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L’avènement des techniques d’ablation percutanée par cathéter a révolutionné le traitement des arythmies cardiaques. Cependant, les ablations complexes demandant une maîtrise technique et pouvant être la source de complications, elles nécessitent un haut niveau d’expertise pour optimiser le taux de succès et minimiser le taux de complications. Au vu de l’absence de recommandations françaises disponibles pour établir les compétences techniques requises, ce document de positionnement a été réalisé par le Groupe de travail de stimulation cardiaque et électrophysiologie de la Société française de cardiologie. Il détaille les caractéristiques requises nécessaires à un centre d’électrophysiologie cardiaque interventionnelle pour la réalisation de procédures d’ablation complexes. 1) volume de procédures par centre. 2) formation, qualification et expérience des électrophysiologistes. 3) formation et présence des paramédicaux. 4) installations et équipement technique du centre. L’importance des capacités diagnostiques, de surveillance et de gestion des complications associées aux ablations complexes est soulignée. Les ressources hospitalières supplémentaires sont discutées, comme l’anesthésie, la possibilité de recours chirurgical, la surveillance intensive, l’assistance hémodynamique et l’imagerie. De plus, les caractéristiques idéales pour un centre de formation en electrophysiologie interventionelle sont décrites. Enfin, les besoins d’évaluation de qualité et de registres nationaux pour les ablations complexes sont discutées.</description><identifier>ISSN: 1875-2136</identifier><identifier>EISSN: 1875-2128</identifier><identifier>DOI: 10.1016/j.acvd.2018.05.006</identifier><identifier>PMID: 30166064</identifier><language>eng</language><publisher>Netherlands: Elsevier Masson SAS</publisher><subject>Ablations complexes ; Arrhythmias, Cardiac - diagnosis ; Arrhythmias, Cardiac - physiopathology ; Arrhythmias, Cardiac - surgery ; Arythmies ventriculaires ; Atrial fibrillation ; Cardiology - education ; Cardiology - standards ; Catheter Ablation - adverse effects ; Catheter Ablation - standards ; Clinical Competence - standards ; Complex ablation procedures ; Consensus ; Credentialing - standards ; Education, Medical, Graduate - standards ; Fibrillation atriale ; France ; French Society of Cardiology ; Humans ; Treatment Outcome ; Ventricular arrhythmia</subject><ispartof>Archives of cardiovascular diseases, 2019-01, Vol.112 (1), p.67-73</ispartof><rights>2018 Elsevier Masson SAS</rights><rights>Copyright © 2018 Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-9e07eda2114fe440b5896623a024ef93f680c114a24b43d09bfbacc9e8661e083</citedby><cites>FETCH-LOGICAL-c356t-9e07eda2114fe440b5896623a024ef93f680c114a24b43d09bfbacc9e8661e083</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.acvd.2018.05.006$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30166064$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maury, Philippe</creatorcontrib><creatorcontrib>Defaye, Pascal</creatorcontrib><creatorcontrib>Klug, Didier</creatorcontrib><creatorcontrib>Alonso, Christine</creatorcontrib><creatorcontrib>Anselme, Frederic</creatorcontrib><creatorcontrib>Fauchier, Laurent</creatorcontrib><creatorcontrib>Gandjbakhch, Estelle</creatorcontrib><creatorcontrib>Gras, Daniel</creatorcontrib><creatorcontrib>Hermida, Jean-Sylvain</creatorcontrib><creatorcontrib>Laurent, Gabriel</creatorcontrib><creatorcontrib>Mansourati, Jacques</creatorcontrib><creatorcontrib>Marijon, Eloi</creatorcontrib><creatorcontrib>Sacher, Frederic</creatorcontrib><creatorcontrib>Taieb, Jérôme</creatorcontrib><creatorcontrib>Boveda, Serge</creatorcontrib><creatorcontrib>Piot, Olivier</creatorcontrib><creatorcontrib>Sadoul, Nicolas</creatorcontrib><creatorcontrib>Working Group of Pacing, Electrophysiology of the French Society of Cardiology</creatorcontrib><title>Position paper concerning the competence, performance and environment required in the practice of complex ablation procedures</title><title>Archives of cardiovascular diseases</title><addtitle>Arch Cardiovasc Dis</addtitle><description>The introduction of catheter ablation techniques has vastly improved the treatment of cardiac arrhythmias. However, as complex ablations are technically demanding and can cause various complications, they require a high level of expertise to maximize success rates and minimize complication rates. As French recommendations regarding the required technical competence and equipment are not yet available, this position paper has been compiled by the Working Group of Pacing and Electrophysiology of the French Society of Cardiology, detailing the required features of an interventional cardiac electrophysiological centre for complex ablation procedures: (1) sufficient institutional volume; (2) physician training, qualifications and experience; (3) paramedical staff training and attendance; and (4) institutional facilities and technical equipment. The importance of being able to diagnose, monitor and manage complications associated with complex ablations is highlighted. Supplemental hospital-based resources are also discussed, such as anaesthesia, surgical back-up, intensive care, haemodynamic assistance and imaging. Further, the ideal features of an interventional cardiac electrophysiology training centre are considered. Lastly, the need for quality evaluations and national registries for complex ablations is discussed.
L’avènement des techniques d’ablation percutanée par cathéter a révolutionné le traitement des arythmies cardiaques. Cependant, les ablations complexes demandant une maîtrise technique et pouvant être la source de complications, elles nécessitent un haut niveau d’expertise pour optimiser le taux de succès et minimiser le taux de complications. Au vu de l’absence de recommandations françaises disponibles pour établir les compétences techniques requises, ce document de positionnement a été réalisé par le Groupe de travail de stimulation cardiaque et électrophysiologie de la Société française de cardiologie. Il détaille les caractéristiques requises nécessaires à un centre d’électrophysiologie cardiaque interventionnelle pour la réalisation de procédures d’ablation complexes. 1) volume de procédures par centre. 2) formation, qualification et expérience des électrophysiologistes. 3) formation et présence des paramédicaux. 4) installations et équipement technique du centre. L’importance des capacités diagnostiques, de surveillance et de gestion des complications associées aux ablations complexes est soulignée. Les ressources hospitalières supplémentaires sont discutées, comme l’anesthésie, la possibilité de recours chirurgical, la surveillance intensive, l’assistance hémodynamique et l’imagerie. De plus, les caractéristiques idéales pour un centre de formation en electrophysiologie interventionelle sont décrites. Enfin, les besoins d’évaluation de qualité et de registres nationaux pour les ablations complexes sont discutées.</description><subject>Ablations complexes</subject><subject>Arrhythmias, Cardiac - diagnosis</subject><subject>Arrhythmias, Cardiac - physiopathology</subject><subject>Arrhythmias, Cardiac - surgery</subject><subject>Arythmies ventriculaires</subject><subject>Atrial fibrillation</subject><subject>Cardiology - education</subject><subject>Cardiology - standards</subject><subject>Catheter Ablation - adverse effects</subject><subject>Catheter Ablation - standards</subject><subject>Clinical Competence - standards</subject><subject>Complex ablation procedures</subject><subject>Consensus</subject><subject>Credentialing - standards</subject><subject>Education, Medical, Graduate - standards</subject><subject>Fibrillation atriale</subject><subject>France</subject><subject>French Society of Cardiology</subject><subject>Humans</subject><subject>Treatment Outcome</subject><subject>Ventricular arrhythmia</subject><issn>1875-2136</issn><issn>1875-2128</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9P3DAQxa2qqCy0X6CHysce2DB2EieRuKAV_6SV4NCeLceegFeJHexkRQ98d7y7wLGnmfG890b-EfKTQcaAifNNpvTWZBxYnUGZAYgvZMHqqlxyxuuvn30ujslJjJsk4FUlvpHjPNkFiGJBXh98tJP1jo5qxEC1dxqDs-6RTk-YxmHECdPbGU3rzodBpYEqZyi6rQ3eDegmGvB5tgENtW7vG4PSk01C3-0zenyhqu3V4VLwGs0cMH4nR53qI_54r6fk7_XVn9Xtcn1_c7e6XC91Xopp2SBUaBRnrOiwKKAt60YInivgBXZN3okadFoqXrRFbqBpu1Zp3WAtBEOo81Py-5CbTj_PGCc52Kix75VDP0fJoakrUbIGkpQfpDr4GAN2cgx2UOGfZCB32OVG7rDLHXYJpUxUk-nXe_7cDmg-LR-ck-DiIMD0y63FIKO2O6wmUdOTNN7-L_8NcjKWIw</recordid><startdate>201901</startdate><enddate>201901</enddate><creator>Maury, Philippe</creator><creator>Defaye, Pascal</creator><creator>Klug, Didier</creator><creator>Alonso, Christine</creator><creator>Anselme, Frederic</creator><creator>Fauchier, Laurent</creator><creator>Gandjbakhch, Estelle</creator><creator>Gras, Daniel</creator><creator>Hermida, Jean-Sylvain</creator><creator>Laurent, Gabriel</creator><creator>Mansourati, Jacques</creator><creator>Marijon, Eloi</creator><creator>Sacher, Frederic</creator><creator>Taieb, Jérôme</creator><creator>Boveda, Serge</creator><creator>Piot, Olivier</creator><creator>Sadoul, Nicolas</creator><general>Elsevier Masson SAS</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201901</creationdate><title>Position paper concerning the competence, performance and environment required in the practice of complex ablation procedures</title><author>Maury, Philippe ; Defaye, Pascal ; Klug, Didier ; Alonso, Christine ; Anselme, Frederic ; Fauchier, Laurent ; Gandjbakhch, Estelle ; Gras, Daniel ; Hermida, Jean-Sylvain ; Laurent, Gabriel ; Mansourati, Jacques ; Marijon, Eloi ; Sacher, Frederic ; Taieb, Jérôme ; Boveda, Serge ; Piot, Olivier ; Sadoul, Nicolas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-9e07eda2114fe440b5896623a024ef93f680c114a24b43d09bfbacc9e8661e083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Ablations complexes</topic><topic>Arrhythmias, Cardiac - diagnosis</topic><topic>Arrhythmias, Cardiac - physiopathology</topic><topic>Arrhythmias, Cardiac - surgery</topic><topic>Arythmies ventriculaires</topic><topic>Atrial fibrillation</topic><topic>Cardiology - education</topic><topic>Cardiology - standards</topic><topic>Catheter Ablation - adverse effects</topic><topic>Catheter Ablation - standards</topic><topic>Clinical Competence - standards</topic><topic>Complex ablation procedures</topic><topic>Consensus</topic><topic>Credentialing - standards</topic><topic>Education, Medical, Graduate - standards</topic><topic>Fibrillation atriale</topic><topic>France</topic><topic>French Society of Cardiology</topic><topic>Humans</topic><topic>Treatment Outcome</topic><topic>Ventricular arrhythmia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maury, Philippe</creatorcontrib><creatorcontrib>Defaye, Pascal</creatorcontrib><creatorcontrib>Klug, Didier</creatorcontrib><creatorcontrib>Alonso, Christine</creatorcontrib><creatorcontrib>Anselme, Frederic</creatorcontrib><creatorcontrib>Fauchier, Laurent</creatorcontrib><creatorcontrib>Gandjbakhch, Estelle</creatorcontrib><creatorcontrib>Gras, Daniel</creatorcontrib><creatorcontrib>Hermida, Jean-Sylvain</creatorcontrib><creatorcontrib>Laurent, Gabriel</creatorcontrib><creatorcontrib>Mansourati, Jacques</creatorcontrib><creatorcontrib>Marijon, Eloi</creatorcontrib><creatorcontrib>Sacher, Frederic</creatorcontrib><creatorcontrib>Taieb, Jérôme</creatorcontrib><creatorcontrib>Boveda, Serge</creatorcontrib><creatorcontrib>Piot, Olivier</creatorcontrib><creatorcontrib>Sadoul, Nicolas</creatorcontrib><creatorcontrib>Working Group of Pacing, Electrophysiology of the French Society of Cardiology</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of cardiovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maury, Philippe</au><au>Defaye, Pascal</au><au>Klug, Didier</au><au>Alonso, Christine</au><au>Anselme, Frederic</au><au>Fauchier, Laurent</au><au>Gandjbakhch, Estelle</au><au>Gras, Daniel</au><au>Hermida, Jean-Sylvain</au><au>Laurent, Gabriel</au><au>Mansourati, Jacques</au><au>Marijon, Eloi</au><au>Sacher, Frederic</au><au>Taieb, Jérôme</au><au>Boveda, Serge</au><au>Piot, Olivier</au><au>Sadoul, Nicolas</au><aucorp>Working Group of Pacing, Electrophysiology of the French Society of Cardiology</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Position paper concerning the competence, performance and environment required in the practice of complex ablation procedures</atitle><jtitle>Archives of cardiovascular diseases</jtitle><addtitle>Arch Cardiovasc Dis</addtitle><date>2019-01</date><risdate>2019</risdate><volume>112</volume><issue>1</issue><spage>67</spage><epage>73</epage><pages>67-73</pages><issn>1875-2136</issn><eissn>1875-2128</eissn><abstract>The introduction of catheter ablation techniques has vastly improved the treatment of cardiac arrhythmias. However, as complex ablations are technically demanding and can cause various complications, they require a high level of expertise to maximize success rates and minimize complication rates. As French recommendations regarding the required technical competence and equipment are not yet available, this position paper has been compiled by the Working Group of Pacing and Electrophysiology of the French Society of Cardiology, detailing the required features of an interventional cardiac electrophysiological centre for complex ablation procedures: (1) sufficient institutional volume; (2) physician training, qualifications and experience; (3) paramedical staff training and attendance; and (4) institutional facilities and technical equipment. The importance of being able to diagnose, monitor and manage complications associated with complex ablations is highlighted. Supplemental hospital-based resources are also discussed, such as anaesthesia, surgical back-up, intensive care, haemodynamic assistance and imaging. Further, the ideal features of an interventional cardiac electrophysiology training centre are considered. Lastly, the need for quality evaluations and national registries for complex ablations is discussed.
L’avènement des techniques d’ablation percutanée par cathéter a révolutionné le traitement des arythmies cardiaques. Cependant, les ablations complexes demandant une maîtrise technique et pouvant être la source de complications, elles nécessitent un haut niveau d’expertise pour optimiser le taux de succès et minimiser le taux de complications. Au vu de l’absence de recommandations françaises disponibles pour établir les compétences techniques requises, ce document de positionnement a été réalisé par le Groupe de travail de stimulation cardiaque et électrophysiologie de la Société française de cardiologie. Il détaille les caractéristiques requises nécessaires à un centre d’électrophysiologie cardiaque interventionnelle pour la réalisation de procédures d’ablation complexes. 1) volume de procédures par centre. 2) formation, qualification et expérience des électrophysiologistes. 3) formation et présence des paramédicaux. 4) installations et équipement technique du centre. L’importance des capacités diagnostiques, de surveillance et de gestion des complications associées aux ablations complexes est soulignée. Les ressources hospitalières supplémentaires sont discutées, comme l’anesthésie, la possibilité de recours chirurgical, la surveillance intensive, l’assistance hémodynamique et l’imagerie. De plus, les caractéristiques idéales pour un centre de formation en electrophysiologie interventionelle sont décrites. Enfin, les besoins d’évaluation de qualité et de registres nationaux pour les ablations complexes sont discutées.</abstract><cop>Netherlands</cop><pub>Elsevier Masson SAS</pub><pmid>30166064</pmid><doi>10.1016/j.acvd.2018.05.006</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Archives of cardiovascular diseases, 2019-01, Vol.112 (1), p.67-73 |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Ablations complexes Arrhythmias, Cardiac - diagnosis Arrhythmias, Cardiac - physiopathology Arrhythmias, Cardiac - surgery Arythmies ventriculaires Atrial fibrillation Cardiology - education Cardiology - standards Catheter Ablation - adverse effects Catheter Ablation - standards Clinical Competence - standards Complex ablation procedures Consensus Credentialing - standards Education, Medical, Graduate - standards Fibrillation atriale France French Society of Cardiology Humans Treatment Outcome Ventricular arrhythmia |
| title | Position paper concerning the competence, performance and environment required in the practice of complex ablation procedures |
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