Catheter ablation of idiopathic ventricular tachycardia without the use of fluoroscopy

Lamberti, Filippo; Clemente, Francesca Di; Remoli, Romolo; Bellini, Cesare; Santis, Antonella De; Mercurio, Marina; Dottori, Serena; Gaspardone, Achille

doi:10.1016/j.ijcard.2015.04.146

Cited by 35 publications

(31 citation statements)

References 22 publications

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“…Some studies have demonstrated the ability of electroanatomic mapping (EAM) systems to minimize or eliminate the unnecessary doses of radiation . However, there are only a few cases published with a full 3D‐mapping system approach and complete elimination of the use of RX . In 2011, we started an RX‐minimization programme in all of our procedures using the CARTO system, with the deliberate intention to not resort to the aid of RX unless strictly necessary.…”

Section: Introductionmentioning

confidence: 99%

“…4 However, there are only a few cases published with a full 3D-mapping system approach and complete elimination of the use of RX. 5,6 In 2011, we started an RXminimization programme in all of our procedures using the CARTO system, with the deliberate intention to not resort to the aid of RX unless strictly necessary. All patients with atrial tachycardia (AT), AFL, and idiopathic VT were considered to be candidates for this "zero-RX" strategy.…”

Section: Introductionmentioning

confidence: 99%

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From near‐zero to zero fluoroscopy catheter ablation procedures

Santoro

Clemente

Baiocchi

et al. 2019

Cardiovasc electrophysiol

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Aims The use of electroanatomical mapping (EAM) systems can reduce radiation exposure (RX) and it can also completely eliminate the use of RX. Radiation exposure related to conventional radiofrequency ablation procedures can have a stochastic and deterministic effect on health. The main aim of this study was to evaluate the safety and feasibility of an entirely nonfluoroscopic approach to catheter ablation (CA) using EAM CARTO3. Methods In 2011 we started an RX‐minimization programme in all procedures using the CARTO system with the deliberate intention to not resort to the aid of RX unless strictly necessary. We divided procedures into two groups (group 1: from 2011 to 2013; group 2: from 2014 to 2017). The only exclusion criteria were the need for transseptal puncture, and nonidiopathic ventricular tachycardia (VT). Results From a total of 525 procedures, we performed CA entirely without RX in 78.5% of cases. From 2011 to 2013, we performed CA without RX in 38.5% of cases; from 2014 to 2017, we performed 96.2% of cases with zero RX. The use of RX was significantly reduced in group 2 (group 2: 1.4 ± 19.6 seconds vs group 1: 556.92 ± 520.76 seconds; P < .001). These differences were irrespective of arrhythmia treatment. There were no differences between the two groups in acute success, complications, or duration of procedures. Conclusion CA of supraventricular tachycardia and VT entirely without RX, guided by the CARTO system, is safe, feasible, and effective. After an adequate learning curve, CA can be performed entirely without RX.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

From near‐zero to zero fluoroscopy catheter ablation procedures

Santoro

Clemente

Baiocchi

et al. 2019

Cardiovasc electrophysiol

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“…The use of 3D mapping systems not only allow correct understanding of the anatomical relationship when one is approaching the ablation target from different sites but also significantly reduce fluoroscopy time. In fact, many of these procedures can be performed completely without the use of fluoroscopy . In a fluoroscopic view it may be difficult to determine where the pulmonary valve is located exactly.…”

Section: Chapter 10: Idiopathic Outflow Tract Ventricular Tachycardiamentioning

confidence: 99%

“…In fact, many of these procedures can be performed completely without the use of fluoroscopy. 251 In a fluoroscopic view it may be difficult to determine where the pulmonary valve is located exactly. Using 3D mapping systems it could be shown that a voltage cutoff value of 1.9 mV accurately delineates the level of the pulmonary valve.…”

Section: Rvot-vtmentioning

confidence: 99%

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2019 APHRS expert consensus statement on three‐dimensional mapping systems for tachycardia developed in collaboration with HRS, EHRA, and LAHRS

Kim

Chen

Ernst

et al. 2020

Journal of Arrhythmia

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Efficacy and safety of zero‐fluoroscopy ablation of ventricular arrhythmias originating from the right ventricular outflow tract: Comparison with fluoroscopy‐guided ablation without a three‐dimensional electroanatomic mapping system

Phan

Pham

et al. 2023

Journal of Arrhythmia

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Background: Radiofrequency catheter ablation is the preferred treatment choice for ventricular arrhythmias (VAs) originating from right ventricular outflow tract (RVOT) in symptomatic patients and is usually performed under fluoroscopy guidance. Zerofluoroscopy (ZF) ablations using 3D mapping system applied for treatment of various types of arrhythmias are trending and practiced in many centers around the world, but rarely done in Vietnam. The objective of this study was to evaluate the efficacy and safety of zero-fluoroscopy ablation of RVOT VAs, compared with fluoroscopyguided ablation without a 3D electroanatomic mapping (EAM) system. Methods and Results:We conducted a nonrandomized, prospective single-center study including 114 patients with RVOT VAs that had electrocardiographic features of typical left bundle branch block, inferior axis QRS morphology, and a precordial transition ≥ V 3 , from May 2020 to July 2022. The patients were assigned (without randomization) to two different approaches of either zero-fluoroscopy ablation under the guidance of the Ensite system (ZF group) or fluoroscopy-guided ablation without a 3D EAM (fluoroscopy group) in a 1:1 ratio. After a follow-up time of 5.0 ± 4.9 months and 6.9 ± 9.3 months in the ZF and fluoroscopy groups, respectively, the results showed a higher success rate in the fluoroscopy group than in the complete ZF group (87.3% vs 86.8%), although the difference was not statistically significant. No major complication was noted in both the groups. Conclusion:ZF ablation for RVOT VAs can be done safely and effectively using the 3D electroanatomic mapping system. The results of ZF approach are comparable to that of the fluoroscopy-guided approach without a 3D EAM system.

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Catheter ablation of idiopathic ventricular tachycardia without the use of fluoroscopy

Cited by 35 publications

References 22 publications

From near‐zero to zero fluoroscopy catheter ablation procedures

From near‐zero to zero fluoroscopy catheter ablation procedures

2019 APHRS expert consensus statement on three‐dimensional mapping systems for tachycardia developed in collaboration with HRS, EHRA, and LAHRS

Efficacy and safety of zero‐fluoroscopy ablation of ventricular arrhythmias originating from the right ventricular outflow tract: Comparison with fluoroscopy‐guided ablation without a three‐dimensional electroanatomic mapping system

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