AI Article Synopsis
- Radiation exposure from traditional radiofrequency catheter ablation (RFCA) can impact health, especially in younger individuals, but nonfluoroscopic mapping significantly reduces or eliminates this exposure.
- This study involved 442 patients, comparing outcomes of RFCA performed with fluoroscopic guidance (145 patients) versus a nonfluoroscopic method (297 patients), with 86% of those in the latter group receiving zero radiation.
- The results showed no significant difference in success rates, procedure times, or complication rates between the two methods, highlighting that the nonfluoroscopic approach can achieve similar outcomes while drastically cutting radiation exposure.
Article Abstract
Background: Radiation exposure related to conventional tachyarrhythmia radiofrequency catheter ablation (RFCA) carries small but not negligible stochastic and deterministic effects on health. These effects are cumulative and potentially more harmful in younger individuals. Nonfluoroscopic mapping systems can significantly reduce the radiological exposure and in some cases it can completely eliminate it.
Objective: The aim of this study was to assess the safety, feasibility, and efficacy of a complete nonfluoroscopic approach for RFCA compared with ablation procedures performed under fluoroscopic guidance.
Methods: RFCA was performed in 442 consecutive patients (mean age 58 ± 19 years). The first 145 patients (group 1) were treated only under fluoroscopic guidance, and the following 297 patients (group 2) were treated using a nonfluoroscopic electroanatomic mapping system (EnSite Velocity). RFCA was completely performed without fluoroscopy in 255 of 297 patients in group 2 (86%).
Results: The acute success rate did not differ between group 1 and group 2 (97% vs 96%; P = .46), and there were no differences in either procedure time (87 ± 57 minutes vs 91 ± 52 minutes; P = .41) or complication rate. Fluoroscopic exposure in group 2 was significantly reduced in comparison with group 1 (14 ± 6 seconds vs 1159 ± 833 seconds; P < .0001).
Conclusion: Compared with the conventional fluoroscopic technique, the near-zero radiation (RX) approach provides similar outcomes and may significantly reduce or eliminate ionizing radiation exposure in RFCA. These reductions are achieved without altering the duration or compromising the safety and effectiveness of the procedure.
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| http://dx.doi.org/10.1016/j.hrthm.2015.09.003 | DOI Listing |
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