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Related Experiment Video

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Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
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From near-zero to zero fluoroscopy catheter ablation procedures.

Amato Santoro1, Francesca Di Clemente2, Claudia Baiocchi1

  • 1Department of Cardiology, Azienda Ospedaliera Universitaria Senese, Siena, Italy.

Journal of Cardiovascular Electrophysiology
|August 20, 2019
PubMed
Summary

This study shows that catheter ablation (CA) using electroanatomical mapping (EAM) systems can eliminate the need for radiation exposure (RX). This nonfluoroscopic approach is safe, feasible, and effective for treating arrhythmias.

Keywords:
catheter ablationelectroanatomic mapping without fluoroscopyzero fluoroscopy

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Area of Science:

  • Cardiology
  • Medical Imaging
  • Electrophysiology

Background:

  • Conventional radiofrequency ablation procedures carry risks associated with radiation exposure (RX).
  • Electroanatomical mapping (EAM) systems offer potential to reduce or eliminate RX during procedures.
  • Evaluating nonfluoroscopic approaches is crucial for patient safety and operator well-being.

Purpose of the Study:

  • To assess the safety and feasibility of catheter ablation (CA) performed entirely without fluoroscopy.
  • To evaluate the effectiveness of the CARTO3 EAM system in guiding nonfluoroscopic CA.
  • To quantify the reduction in RX achieved through an EAM-guided approach.

Main Methods:

  • A retrospective analysis of 525 catheter ablation procedures using the CARTO3 EAM system.
  • Procedures were divided into two groups based on implementation of an RX-minimization program (2011-2013 vs. 2014-2017).
  • Exclusion criteria included transseptal puncture and nonidiopathic ventricular tachycardia (VT).

Main Results:

  • Catheter ablation was performed entirely without RX in 78.5% of all cases.
  • The rate of zero-RX procedures increased from 38.5% (2011-2013) to 96.2% (2014-2017).
  • Significant reduction in RX duration was observed in the later period (1.4 ± 19.6 seconds vs. 556.92 ± 520.76 seconds; P < .001) without compromising acute success, complications, or procedure duration.

Conclusions:

  • Catheter ablation guided by the CARTO3 EAM system is safe, feasible, and effective without fluoroscopy.
  • An adequate learning curve allows for complete elimination of RX in CA procedures.
  • This nonfluoroscopic approach significantly reduces patient and staff radiation exposure.