Catheter Ablation of Common‐Type Atrial Flutter Guided by Three‐Dimensional Right Atrial Geometry Reconstruction and Catheter Tracking Using Cutaneous Patches:

Abstract

NavX technology allows geometry reconstruction of the cavotricuspid isthmus. NavX-guided ablation of AFL reduces total x-ray exposure compared to the fluoroscopy-guided approach but does not prolong procedure time.

Is It Possible to Perform a Linear Lesion with No Local Electrograms Using a Three-Dimensional Mapping System for the Ablation of Typical Atrial Flutter?

“…2, 3). In cases of displacement, the catheter can be returned easily to its original location [11, 12]. …”

A family of intracardiac ultrasound imaging devices designed for guidance of electrophysiology ablation procedures

“…The CARTO system has been employed by investigators [10], [11], [12], [13], all showing significantly decreased radiation exposure. Additionally, the NavX system [10], [14], [15], [16], provided marked reductions in radiation and shortening of procedure time that offer compelling rationale for the utility of these guidance systems.…”

Multifunctional catheters combining intracardiac ultrasound imaging and electrophysiology sensing

“…Since fluoroscopy remains the current standard for EP therapeutic guidance to direct catheter position and movement, the consequence for patients is long periods of radiation exposure during ablation procedures taking as long as 3 h [35]. Average exposure times of 20 min [36] and 22 min [37] for isthmus ablation procedures to correct atrial flutter in the readily accessible right atrium are not uncommon. EP ablation therapy in the LA can expose patients to more than 21 [38] to 50 [39] min of fluoroscopic radiation.…”

“…The common total exposure metric is taken as the gray per unit time, times an area of exposure, times the time used, usually stated in dose-area-product (DAP) units of centigray centimeter squared, or cGy-cm 2 . A patient undergoing an AF ablation procedure, for example, may experience a DAP exposure of 2590 cGy-cm 2 [36], and if one assumes a 10 cm square exposure, the total dose is then 0.26 Gy (or 0.26 Sv). For reference, a typical equivalent annual dose of radiation from natural sources is 2.5 mSv; for patients undergoing fluoroscopic exposure of a small region of the body, transient erythema (skin redness) can occur at 2 Sv, permanent skin epilation at 7 Sv, and late onset dermal necrosis at levels above 10 to 12 Sv [41].…”