Factors associated with fluoroscopy exposure during pediatric catheter ablation utilizing electroanatomical mapping

Abstract

Electroanatomical navigation significantly reduced fluoroscopic exposure without compromising safety, efficacy, or recurrence. Subjects with AVNRT and right-sided accessory pathways derived the greatest benefit as did those requiring prolonged fluoroscopy by the conventional approach.

Efficacy and Safety of Radiofrequency Catheter Ablation of Tachyarrhythmias in 123 Children Under 3 Years of Age

“…To reduce the effects of x‐ray exposure in pediatric patients, several measures have been adopted at our center: choosing a low‐dose x‐ray projection process, reducing the distance between the projection tube and the child's body, constantly adjusting the scope of vision according to the needs of the procedure, and using a lead apron to cover the patient's gonads. Application of 3D electroanatomical mapping in RFCA can also significantly reduce the time of x‐ray exposure . We have applied the 3D CARTO system to guide RFCA to minimize x‐ray exposure during the procedure, obtain accurate target positioning, and achieve clarity in displays of anatomical structure.…”

Single center experience of fluoroless AVNRT ablation guided by electroanatomic reconstruction in children and adolescents

“…Very few authors have focused on the complete elimination of fluoroscopy. To our knowledge, 4 studies reported zero-fluoroscopy AVNRT ablation in children in the great majority of cases [14][15][16][17] .…”

“…Recently, it has been shown that non fluoroscopic electroanatomic (EA) mapping systems allows to reduce X-ray exposure for ablation procedures in children [10][11][12][13][14] . In addition, in few reports the feasibility of fluoroless procedures in children and adolescents has been demonstrated [14][15][16][17] , with a similar success and complication rate compared to conventional standard ablation procedures.…”

“…In addition, in few reports the feasibility of fluoroless procedures in children and adolescents has been demonstrated [14][15][16][17] , with a similar success and complication rate compared to conventional standard ablation procedures.…”

Patient and Procedural Correlates of Fluoroscopy Use During Catheter Ablation in the Pediatric and Congenital Electrophysiology Lab

“…A recent study characterized factors associated with increased fluoroscopy time in a comparison between conventional ablation and 3D mappingassisted ablation. 16 A prospective randomized controlled trial designed to assess this question is ongoing. 17 In laboratories employing concerted low-fluoroscopy efforts, including the consistent use of 3D mapping, the variables that characterize electrophysiology cases failing to achieve singledigit fluoroscopy times remain undefined.…”