[Fluoroscopic guidance in electrophysiological procedures]

Fluoroscopic orientation remains a fundamental tool in invasive electrophysiology despite the increasing use of three-dimensional mapping. Particularly for early-career electrophysiologists, fluoroscopy is not only a means of catheter navigation but also an important safety tool for rapidly assessing spatial relationships, catheter stability, and potential complications. It continues to provide clear practical information during complex maneuvers such as transseptal puncture, right atrial ablation, atrial fibrillation ablation, and pericardial access. Safe and effective use of fluoroscopy requires specific anatomical and topographical knowledge. Orientation is typically based on defined anatomical landmarks visualized in standard projections. This article provides an overview of the most relevant fluoroscopic landmarks, their appearance and localization on fluoroscopic imaging, and the standard views commonly used in electrophysiological procedures.