Atrioventricular node ablation and permanent ventricular pacemaker implantation without fluoroscopy: use of an...

Area of Science:

• Clinical Electrophysiology
• Cardiovascular Interventions
• Medical Imaging Technology

Background:

• Fluoroscopic guidance is standard for transvenous pacemaker implantation and ablation procedures.
• Fluoroscopy involves significant X-ray exposure, posing risks to patients and healthcare professionals.
• Minimizing radiation is crucial in cardiac interventions.

Observation:

• A 47-year-old male patient with uncontrollable permanent atrial fibrillation underwent a complete procedure without fluoroscopy.
• The procedure involved ablation of atrioventricular (AV) conduction and permanent ventricular pacemaker implantation.
• Guidance was solely provided by the EnSite NavX electroanatomic navigation system.

Findings:

• Successful completion of both AV ablation and pacemaker implantation using only non-fluoroscopic navigation.
• The EnSite NavX system enabled precise guidance for the entire complex procedure.
• This case highlights the feasibility of a completely fluoroscopy-free approach.

Implications:

• Non-fluoroscopic navigation systems can replace traditional fluoroscopy for combined AV ablation and pacemaker implantation.
• This approach significantly reduces radiation exposure, enhancing patient and operator safety.
• It paves the way for safer, radiation-free cardiac electrophysiology procedures.