The Benefits of 3D Mapping Systems for Ablation of WPW in Children

State of Fluoroless Procedures in Cardiac Electrophysiology Practice

“…Of note, a multicenter study has shown a higher success rate of three-dimensional EAM-guided procedures as compared with procedures directed by fluoroscopy alone (97% versus 91%) for the ablation of accessory pathways in a pediatric population, with no significant difference in recurrence (5% versus 9%) or complication rates (0.3% versus 0.4%). 39 In another multicenter study including 442 consecutive adult patients with SVT (43% AVNRT; 35% right-sided AFL; 11% accessory pathway; and 11% AT, atypical AFL, or VT), Giaccardi et al 40 also demonstrated the efficacy (acute success rate of 96% versus 97%) and safety (complication rate of 4.4% versus 2.1%) of near-zero fluoroscopy with the aid of the EnS-ite™ Velocity™ system (Abbott Laboratories, Chicago, IL, USA) in comparison with the conventional approach, without a significant increase in procedural duration (91 ± 52 minutes versus 87 ± 57 minutes). Importantly, 14% of the patients required rescue fluoroscopy because of difficult venous access, need to confirm catheter stability and location, frequent coronary sinus (CS) catheter dislocation, problems with the EAM system, and a need to check the positioning of guidewires.…”