Related Experiment Video
Updated: Aug 9, 2025

Reduced Procedure Time and Variability with Active Esophageal Cooling During Radiofrequency Ablation for Atrial Fibrillation
Published on: August 25, 2022
Adding interactive face-to-face lectures to passive lectures effectively reduces radiation exposure during atrial
Yuichiro Miyazaki1, Kenichiro Yamagata2, Akinori Wakamiya2
1Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Background:
Radiation exposure remains a major concern for electrophysiologists and patients. This study aimed to investigate the effect of altering awareness of radiation exposure during atrial fibrillation ablation using interactive face-to-face (FTF) lectures compared to passive lectures.
Methods:
Patients who underwent their first catheter ablation with radiofrequency energy for atrial fibrillation between January 2014 and December 2020 were included in this study. All operators attended an e-learning lecture on radiation exposure before catheter ablation. The addition of FTF lectures to this lecture was introduced in 2018. The effect on radiation exposure was compared between the pre-FTF and FTF periods by comparing fluoroscopy time and radiation dose.
Results:
A total of 896 patients [mean age, 66 ± 11 years; 603 men (67 %)] were included in this study. For pre-FTF (n = 345), only pulmonary vein isolation (PVI) was performed in 112 patients and PVI with additional ablation in 233 patients. For FTF lectures (n = 551), PVI-only was performed in 302 patients and PVI with additional ablation in 249 patients. Fluoroscopy time, cumulative air kerma, and cumulative air kerma per time significantly reduced after FTF introduction in both PVI-only group [pre-FTF and FTF; 37 ± 15 min and 16 ± 10 min (p < 0.0001), 477 ± 582 mGy and 108 ± 156 mGy (p < 0.0001), 11 ± 12 mGy/min, and 5 ± 6 mGy/min (p < 0.0001), respectively] and PVI with additional ablation group [pre-FTF and FTF; 48 ± 17 min and 15 ± 13 min (p < 0.0001), 613 ± 483 mGy and 68 ± 96 mGy (p < 0.0001), 12 ± 10 mGy/min, and 4 ± 4 mGy/min (p < 0.0001), respectively]. There were no significant differences in intraoperative complications between the two periods.
Conclusions:
FTF lectures can reduce radiation exposure.

