A Novel Technique for Zero-Fluoroscopy Catheter Ablation Used to Manage Wolff–Parkinson–White Syndrome With a Left-Sided Accessory Pathway

Kerst, Gunter; Parade, Ulli; Weig, Hans-Jörg; Hofbeck, Michael; Gawaz, Meinrad; Schreieck, Jürgen

doi:10.1007/s00246-012-0207-x

Cited by 13 publications

(6 citation statements)

References 11 publications

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“…Recently, the zero fluoroscopy approach has been demonstrated to be safe and effective to ablate supraventricular arrhythmias and accessory pathways. [122][123][124] The zero fluoroscopy ablation is particularly attractive for children and adolescents owing to the absence of risk for radiation-related damages.…”

Section: Primary Arrhythmiasmentioning

confidence: 99%

Sudden cardiac death in the young: the bogeyman

et al. 2014

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Sudden cardiac death in the young is a relatively uncommon but marked event usually related to congenital diseases or anomalies. Despite the prevalence of each condition being variable, most common causes include primary myocardial diseases and arrhythmic disorder, frequently with inheritance pattern. Sudden cardiac death is usually preceded by symptoms, thus making personal and family history fundamental for its prevention. Nevertheless, in more than 50% of cases, sudden cardiac death is the first manifestation of the disease. In this review, we describe the different causes of sudden cardiac death, their incidence, and currently used preventive strategies.

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Section: Primary Arrhythmiasmentioning

confidence: 99%

Sudden cardiac death in the young: the bogeyman

et al. 2014

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“…Therefore, successful development of zero-fluoroscopy ablation methods will allow broad application prospects in the future. Second, similar to previous zero-fluoroscopy studies, [ 3 , 5 , 6 , 8 , 10 ] ST catheter application was essential for performing mapping and ablation in this study. Soft manipulation and accurate reconstruction and mapping enable successful completion of the operation.…”

Section: Discussionmentioning

confidence: 60%

“…[ 1 , 2 , 4 – 10 , 15 , 18 ] Our center has also contributed related reports to the literature. [ 3 ] Most centers require intracardiac echocardiography (ICE) guidance, [ 11 , 15 ] Carto Univu systems [ 1 , 15 ] or pressure catheters [ 3 , 5 , 6 , 8 , 10 ] for zero-fluoroscopy radiofrequency ablation. In addition, DSA operating rooms require multiple conductive physiologic systems for cardiac electrophysiology operations.…”

Section: Discussionmentioning

confidence: 99%

Catheter radiofrequency ablation for arrhythmias under the guidance of the Carto 3 three-dimensional mapping system in an operating room without digital subtraction angiography

Huang¹,

Chen

Huang³

et al. 2018

Medicine

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Several studies have reported the efficacy of a zero-fluoroscopy approach for catheter radiofrequency ablation of arrhythmias in a digital subtraction angiography (DSA) room. However, no reports are available on the ablation of arrhythmias in the absence of DSA in the operating room. To investigate the efficacy and safety of catheter radiofrequency ablation for arrhythmias under the guidance of a Carto 3 three-dimensional (3D) mapping system in an operating room without DSA. Patients were enrolled according to the type of arrhythmia. The Carto 3 mapping system was used to reconstruct heart models and guide the electrophysiologic examination, mapping, and ablation. The total procedure, reconstruction, electrophysiologic examination, and mapping times were recorded. Furthermore, immediate success rates and complications were also recorded. A total of 20 patients were enrolled, including 12 males. The average age was 51.3 ± 17.2 (19–76) years. Nine cases of atrioventricular nodal re-entrant tachycardia, 7 cases of frequent ventricular premature contractions, 3 cases of Wolff–Parkinson–White syndrome, and 1 case of typical atrial flutter were included. All arrhythmias were successfully ablated. The procedure time was 127.0 ± 21.0 (99–177) minutes, the reconstruction time was 6.5 ± 2.9 (3–14) minutes, the electrophysiologic study time was 10.4 ± 3.4 (6–20) minutes, and the mapping time was 11.7 ± 8.3 (3–36) minutes. No complications occurred. Radiofrequency ablation of arrhythmias without DSA is effective and feasible under the guidance of the Carto 3 mapping system. However, the electrophysiology physician must have sufficient experience, and related emergency measures must be present to ensure safety.

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“…4–7,9–13,15–19 Kühne et al advocate using transesophageal echocardiography (TEE) prior to TSP access, 10 whereas several groups describe intra-procedural TEE-guided TSP access with a high degree (97–100%) of AF-free event rates during respective follow-up periods. 13,16,17 Other groups have described TEE-guided TSP in combination with fluoroscopy to minimise radiation exposure, however reported outcomes from this approach demonstrated comparatively reduced AF-free success rates (75–85%). 4,5,12 No groups have reported EAM-only ZFTSP access, but Clark et al have demonstrated that EAM-guided TSP access combined with fluoroscopy is feasible.…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopy-free Atrial Transseptal Puncture

McCauley¹,

Patel²,

Greenberg³

et al. 2016

European Journal of Arrhythmia &Amp; Electrophysiology

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Introduction Fluoroscopy is traditionally used in atrial transseptal puncture (TSP); however fluoroscopy exposes patient and physician to excess radiation. Here, we describe a feasibility study of a zero-fluoroscopy transseptal puncture (ZFTSP) technique utilising electroanatomical mapping (EAM) and intracardiac echo (ICE) in a small case series of patients undergoing ablation for atrial fibrillation (AF). We then compare this technique to other established ZFTSP techniques for paroxysmal AF ablation. Methods Seven patients received ZFTSP. An Acunav™ ICE catheter (Biosense Webster Inc., California, US) was placed in the right atrium, then an Agilis™ sheath (St. Jude Medical, Saint Paul, Minnesota, US) was established into the inferior vena cava. A ThermoCool® SmartTouch™ catheter (Biosense Webster Inc., California, US) was inserted through the Agilis to map the fossa ovalis. Mapping catheter exchange for dilator and needle allowed for facile ZFTSP. AF outcome, fluoroscopy times, and procedure times were compared with eight age-matched control patients. Results There were no significant differences in age, body mass index (BMI) or AF duration between the two groups and no immediate complications. ZFTSP procedure time was 183.9±33.7 minutes versus 293.13±129.9 minutes for TSP-only controls (p=0.05). Fluoroscopy time was 17.5±14.1 minutes in ZFTSP patients versus 73.4±50.3 minutes in controls (p=0.01). AF recurrence in ZFTSP patients was 14% versus 25% in controls. Conclusion ZFTSP utilising ICE and EAM is safe, effective, and time-efficient. There is a small but significant reduction in radiation exposure to patient and physician by the use of this technique.

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A Novel Technique for Zero-Fluoroscopy Catheter Ablation Used to Manage Wolff–Parkinson–White Syndrome With a Left-Sided Accessory Pathway

Cited by 13 publications

References 11 publications

Sudden cardiac death in the young: the bogeyman

Sudden cardiac death in the young: the bogeyman

Catheter radiofrequency ablation for arrhythmias under the guidance of the Carto 3 three-dimensional mapping system in an operating room without digital subtraction angiography

Fluoroscopy-free Atrial Transseptal Puncture

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