Fluoroless Catheter Ablation of Cardiac Arrhythmias

Demo, Hany; Willoughby, Cameron; Jazayeri, Mohammad-Ali; Razminia, Mansour

doi:10.1016/j.ccep.2019.08.013

Cited by 13 publications

(11 citation statements)

References 12 publications

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“…1,2 With the development of contact forcesensing catheters, EAM, transesophageal echocardiography (TEE), and ICE probes, zero-fluoroscopy procedures have received increased attention from electrophysiologists. 4,7,8 Transseptal puncture is a key step of this procedure. With use of the transseptal puncture method, zero-fluoroscopy methods can be performed in two ways, with TEE or ICE.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the fact that the procedure can improve the quality of life for patients, radiation exposure can lead to malignancies, genetic defects, skin injury, cataract, and other complications, with the potential for negative effects on the health of doctors and patients 1,2 . With the development of contact force‐sensing catheters, EAM, transesophageal echocardiography (TEE), and ICE probes, zero‐fluoroscopy procedures have received increased attention from electrophysiologists 4,7,8 …”

Section: Discussionmentioning

confidence: 99%

“…Zero-fluoroscopy procedures have recently become feasible because of the development of contact force-sensing catheters, electroanatomical mapping systems (EAMs), and intracardiac echocardiography (ICE) probes. 4 ICE-guided radiofrequency catheter ablation (RFCA) has been studied in this context. [5][6][7] However, few studies have investigated the application of ICE to procedures involving the atrial septum.…”

Section: Introductionmentioning

confidence: 99%

“…The “as low as reasonably achievable” principle advocates limited radiation usage and proposes several methods to reduce radiation exposure, 3 such as zero‐fluoroscopy procedures. Zero‐fluoroscopy procedures have recently become feasible because of the development of contact force‐sensing catheters, electroanatomical mapping systems (EAMs), and intracardiac echocardiography (ICE) probes 4 . ICE‐guided radiofrequency catheter ablation (RFCA) has been studied in this context 5‐7 .…”

Section: Introductionmentioning

confidence: 99%

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Zero‐fluoroscopy transseptal puncture guided by right atrial electroanatomical mapping combined with intracardiac echocardiography: A single‐center experience

Zhang

Cheng

Liang

et al. 2020

Clinical Cardiology

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Background Right atrial electroanatomical mapping may be combined with SoundStar 3D diagnostic ultrasound catheter (EAM‐ICE) as a zero‐fluoroscopy procedure for radiofrequency catheter ablation (RFCA). We aimed to evaluate the efficiency and safety of zero‐fluoroscopy transseptal puncture guided by EAM‐ICE and fluoroscopy combined with intracardiac echocardiography (F‐ICE) in patients with paroxysmal atrial fibrillation (PAF). Hypothesis Zero‐fluoroscopy transseptal puncture is an effective and safe procedure. Methods This study had a prospective design. A total of 57 patients with PAF were enrolled and assigned to two groups. Twenty‐seven patients were enrolled in the EAM‐ICE group, and 30 patients were enrolled in the F‐ICE group. Results There were no statistically significant differences in baseline patient characteristics between groups. Transseptal puncture was successful in all patients (57/57, 100%). Total procedure time and duration of transseptal puncture were lower in the F‐ICE group (199.4 ± 26.0 minutes vs 150.7 ± 22.1 minutes, P = 0.000; 118.4 ± 19.7 vs 70.5 ± 13.5 minutes, P = 0.000). There was no use of fluoroscopy in the EAM‐ICE group (0 mGy vs 70.5 ± 13.5 mGy); the duration of fluoroscopy in the EAM‐ICE group was negligible (0 minutes vs 5.4 ± 1.9 minutes). No procedural complication occurred in either group. Conclusions EAM‐ICE guided zero‐fluoroscopy transseptal puncture is an effective and safe procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Zero‐fluoroscopy transseptal puncture guided by right atrial electroanatomical mapping combined with intracardiac echocardiography: A single‐center experience

Zhang

Cheng

Liang

et al. 2020

Clinical Cardiology

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“…For that matter, it is of utmost importance that ICE, and EA mapping be used to their best advantage. [17][18][19][20][21] Our series represents a pioneer experience in Brazil and Latin America using a radiation-free approach. It resulted from a long-lasting concern about radiation reduction and steady implementation of non-X-ray steps to our ablation protocol.…”

Section: Discussionmentioning

confidence: 99%

Ablação Por Cateter Sem Uso de Fluoroscopia Para Tratamento de Fibrilação Atrial e Arritmias Atriais: Eficácia e Segurança

Saad¹,

Slater²,

Inácio³

et al. 2020

Arquivos Brasileiros De Cardiologia

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Background: The use of ionizing radiation in medical procedures is associated with significant health risks for patients and the health care team. Objectives: Evaluate the safety and acute efficacy of ablation for atrial fibrillation (AF) and supraventricular arrhythmias (SVTs) using an exclusively non-fluoroscopic approach guided by intracardiac echo (ICE) and 3D-mapping. Methods: 95 pts (mean age 60 ± 18 years, 61% male) scheduled for AF Ablation (69 pts, 45 paroxysmal AF and 24 persistent AF) or non-AF SVT (26 pts-14 AV node reentry, 6 WPW, 5 right atrial (RA) flutters, 1 atrial tachycardia) underwent zero fluoro procedures. Nine patients (9.5%) had permanent pacemakers or defibrillator resynchronization (CRT-D) devices. Both CARTO (65%) and NAVx (35%) mapping systems were used, as well as Acunav and ViewFlex ICE catheters. Results: Pulmonary vein isolation (PVI), as well as all other targets that needed ablation in both atria were reached and adequately visualized. No pericardial effusions, thrombotic complications or other difficulties were seen in these series. Difficult transseptal puncture (19 patients-20%) was managed without fluoroscopy in all cases. No backup fluoroscopy was used, and no lead apparel was needed. Pacemaker interrogations after the procedure did not show any lead damage, dislocation, or threshold changes. Conclusions: A radiation-free (fluoroless) catheter ablation strategy for AF and other atrial arrhythmias is acutely safe and effective when guided by adequate ICE and 3D-mapping utilization. Multiple different bi-atrial sites were reached and adequately ablated without the need for backup fluoroscopy. No complications were seen.

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Fluoroless catheter ablation of accessory pathways in adult and pediatric patients: a single centre experience

Yazıcı

Lakič

Kalinšek

et al. 2021

Int J Cardiovasc Imaging

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Fluoroless Catheter Ablation of Cardiac Arrhythmias

Cited by 13 publications

References 12 publications

Zero‐fluoroscopy transseptal puncture guided by right atrial electroanatomical mapping combined with intracardiac echocardiography: A single‐center experience

Zero‐fluoroscopy transseptal puncture guided by right atrial electroanatomical mapping combined with intracardiac echocardiography: A single‐center experience

Ablação Por Cateter Sem Uso de Fluoroscopia Para Tratamento de Fibrilação Atrial e Arritmias Atriais: Eficácia e Segurança

Fluoroless catheter ablation of accessory pathways in adult and pediatric patients: a single centre experience

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