Zero fluoroscopy atrioventricular node ablation and left bundle branch pacing guided by electroanatomic
Sebastián Giacoman1, María Algarra1, Ana Delia Ruiz1
1Cardiac Arrhythmia and Electrophysiology Unit, Department of Cardiology, Hospital Universitario Clínico San Cecilio, Av. del Conocimiento, s/n Granada 18016, Spain.
Journal of Cardiology Cases
|January 26, 2022
Summary
This study demonstrates zero fluoroscopy left bundle branch pacing and atrioventricular node ablation guided by an electroanatomic mapping system. This technique offers a viable alternative when radiation exposure is a concern.
Area of Science:
- Electrophysiology
- Cardiovascular Medicine
- Medical Technology
Background:
- Atrioventricular node ablation (AVNA) and His-bundle pacing are established procedures, often utilizing electroanatomic tridimensional mapping systems (ETMS).
- Zero fluoroscopy techniques are increasingly explored to minimize radiation exposure in cardiac interventions.
Observation:
- A case report details a 65-year-old female patient undergoing left bundle branch pacing and AVNA. The procedure was exclusively guided by ETMS, eliminating the need for fluoroscopy.
- Device function, lead stability, and electrical parameters were assessed at 24 hours and 30 days post-procedure.
Findings:
- The zero fluoroscopy approach using ETMS for combined left bundle branch pacing and AVNA proved successful.
- Optimal device functioning and stable electrical parameters were maintained throughout the follow-up period, indicating successful lead placement and performance.
Implications:
- This ETMS-guided, zero fluoroscopy technique presents a safe and effective alternative for combined AVNA and ventricular pacing, particularly in patients where radiation avoidance is critical.
- It highlights the potential for advanced mapping systems to facilitate complex cardiac procedures with reduced risks.
