Nonfluoroscopic Catheter Ablation of Cardiac Arrhythmias in Adults: Feasibility, Safety, and Efficacy

Razminia, F.A.C.C. Mansour; Manankil, Marian F.; Eryazici, Paula; Arrieta-Garcia, Carlos; Wang, F.A.C.C. Theodore; D’Silva, Oliver; S., Lopez, Christian; Crystal, F.A.H.A. George J.; Khan, Saba; Stancu, Mihaela; Turner, R; Anthony, R N Joseph; Zheutlin, F.A.C.C. Terry A.; Kehoe, Fiona

doi:10.1111/j.1540-8167.2012.02344.x

Cited by 62 publications

(87 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Alternative imaging systems, such as electroanatomic mapping and intracardiac echocardiography, have led to the ability to perform SVT ablation with no or minimal fluoroscopy, with success and complication rates similar to standard techniques (73)(74)(75)(76)(77). A reduced-fluoroscopy approach is particularly important in pediatric patients and during pregnancy (78,79).…”

Section: Basic Principles Of Electrophysiological Study Mapping Andmentioning

confidence: 97%

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary

Page¹,

Joglar²,

Caldwell³

et al. 2016

Journal of the American College of Cardiology

View full text Add to dashboard Cite

Section: Basic Principles Of Electrophysiological Study Mapping Andmentioning

confidence: 97%

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary

Page¹,

Joglar²,

Caldwell³

et al. 2016

Journal of the American College of Cardiology

View full text Add to dashboard Cite

“…1–3 Recent publications demonstrated that completely non-fluoroscopic ablation procedures based on 3D systems and intracardiac echocardiography are feasible. 11–15 However, current real-world data, as recently presented in a European Heart Rhythm Association survey by Estner et al ., 16 show that fluoroscopy still remains the basic imaging modality in EP procedures. For complex procedures, a median fluoroscopy time of 16 min and a cumulative DAP of 6100 µGym² are reported.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a new very low dose imaging protocol: feasibility and impact on X-ray dose levels in electrophysiology procedures

Bourier¹,

Reents²,

Ammar-Busch³

et al. 2015

Europace

View full text Add to dashboard Cite

AimsThis study presents and evaluates the impact of a new lowest-dose fluoroscopy protocol (Siemens AG), especially designed for electrophysiology (EP) procedures, on X-ray dose levels.Methods and resultsFrom October 2014 to March 2015, 140 patients underwent an EP study on an Artis zee angiography system. The standard low-dose protocol was operated at 23 nGy (fluoroscopy) and at 120 nGy (cine-loop), the new lowest-dose protocol was operated at 8 nGy (fluoroscopy) and at 36 nGy (cine-loop). Procedural data, X-ray times, and doses were analysed in 100 complex left atrial and in 40 standard EP procedures. The resulting dose–area products were 877.9 ± 624.7 µGym² (n = 50 complex procedures, standard low dose), 199 ± 159.6 µGym² (n = 50 complex procedures, lowest dose), 387.7 ± 36.0 µGym² (n = 20 standard procedures, standard low dose), and 90.7 ± 62.3 µGym² (n = 20 standard procedures, lowest dose), P < 0.01. In the low-dose and lowest-dose groups, procedure times were 132.6 ± 35.7 vs. 126.7 ± 34.7 min (P = 0.40, complex procedures) and 72.3 ± 20.9 vs. 85.2 ± 44.1 min (P = 0.24, standard procedures), radiofrequency (RF) times were 53.8 ± 26.1 vs. 50.4 ± 29.4 min (P = 0.54, complex procedures) and 10.1 ± 9.9 vs. 12.2 ± 14.7 min (P = 0.60, standard procedures). One complication occurred in the standard low-dose and lowest-dose groups (P = 1.0).ConclusionThe new lowest-dose imaging protocol reduces X-ray dose levels by 77% compared with the currently available standard low-dose protocol. From an operator standpoint, lowest X-ray dose levels create a different, reduced image quality. The new image quality did not significantly affect procedure or RF times and did not result in higher complication rates. Regarding radiological protection, operating at lowest-dose settings should become standard in EP procedures.

show abstract

“…Consequently there is increasing interest in methods to minimize radiation exposure during catheter procedures. Many authors have shown that we have the technology to achieve this aim at least in supraventricular arrhythmias including AF ablation [9,10,12,17]. On the other side, to our knowledge, there is just one study focused on fluoroscopy reduction during idiopathic VT ablation procedures [13], enrolling a pediatric population only.…”

Section: Previous Studiesmentioning

confidence: 95%

Catheter ablation of idiopathic ventricular tachycardia without the use of fluoroscopy

Lamberti

Clemente

Remoli

et al. 2015

International Journal of Cardiology

View full text Add to dashboard Cite

Nonfluoroscopic Catheter Ablation of Cardiac Arrhythmias in Adults: Feasibility, Safety, and Efficacy

Cited by 62 publications

References 38 publications

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary

Evaluation of a new very low dose imaging protocol: feasibility and impact on X-ray dose levels in electrophysiology procedures

Catheter ablation of idiopathic ventricular tachycardia without the use of fluoroscopy

Contact Info

Product

Resources

About