Safety and feasibility of catheter ablation for atrioventricular nodal re-entrant tachycardia without fluoroscopic guidance.

Background: Nonfluoroscopic intracardiac navigation systems reduce the dose of radiation in most ablation procedures. However, they have not been sufficiently studied as a sole guidance tool for electrode catheter handling.

Objective: The purpose of our study was to assess the feasibility and safety of catheter ablation for atrioventricular nodal re-entrant tachycardia (AVNRT) without the use of fluoroscopy.

Methods: We prospectively enrolled all of the patients with AVNRT (Group A) treated by catheter ablation guided only by a nonfluoroscopic intracardiac navigation system. These patients were compared with a matched control group of patients (Group B) who had undergone an ablation procedure for AVNRT guided only by fluoroscopy in the preceding months. We compared the success rate and the rate of complications and recurrences. We also compared the procedure and radiofrequency times.

Results: Fifty patients were enrolled in each group. The procedure was successful in 100% in Group A versus 96% in Group B (P = .15). One patient in Group A and 4 patients in Group B suffered nonserious complications (P = NS). The mean fluoroscopy time in Group B was 18 +/- 16 min (range 3.5 to 77, total 924). In 1 case in Group A (2%), the use of fluoroscopy was required. Procedure and radiofrequency times did not differ between the 2 groups. A recurrence developed in 2 patients in each group (P = NS).

Conclusions: Catheter ablation for AVNRT without fluoroscopic guidance is feasible and safe, and does not prolong procedure time. The reduction in radiation dose is considerable for patients and professionals.