Near-zero x-ray in arrhythmia ablation using a 3-dimensional electroanatomic mapping system: A multicenter...

Area of Science:

• Cardiology
• Medical Imaging
• Electrophysiology

Background:

• Conventional radiofrequency catheter ablation (RFCA) for tachyarrhythmia involves radiation exposure with cumulative health risks, particularly for younger patients.
• Nonfluoroscopic mapping systems offer a potential solution to minimize or eliminate this radiological exposure.

Purpose of the Study:

• To evaluate the safety, feasibility, and efficacy of a completely nonfluoroscopic RFCA approach.
• To compare outcomes with standard fluoroscopic guidance.

Main Methods:

• 442 patients underwent RFCA; 145 used fluoroscopic guidance (group 1), and 297 used a nonfluoroscopic electroanatomic mapping system (group 2).
• 86% of group 2 patients (255/297) had procedures performed entirely without fluoroscopy.

Main Results:

• Acute success rates were comparable between groups (97% vs. 96%).
• Procedure times and complication rates were similar in both groups.
• Fluoroscopic exposure was dramatically reduced in group 2 (14 seconds) compared to group 1 (1159 seconds).

Conclusions:

• A near-zero radiation (RX) approach using nonfluoroscopic mapping is as effective and safe as conventional fluoroscopic RFCA.
• This technique significantly reduces or eliminates ionizing radiation exposure during RFCA.
• The nonfluoroscopic method does not increase procedure duration or compromise patient safety and effectiveness.