A Zero‐Fluoroscopy Approach to Cavotricuspid Isthmus Catheter Ablation: Comparative Analysis of Two Electroanatomical Mapping Systems

Macías, Rosa; Uribe, I.; Tercedor, Luís; Jiménez‐Jáimez, Juan; Barrio, Teresa; Álvarez, Miguel

doi:10.1111/pace.12376

Cited by 30 publications

(15 citation statements)

References 28 publications

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“…To our knowledge, this is the largest series of cases of tachycardia ablation performed without fluoroscopy. Our data are consistent with other international series, 15,[18][19][20][21][22] confirming the safety, feasibility, and efficacy of the nonfluoroscopic EnSite Velocity mapping system as an exclusive or partially exclusive guide in ablation procedures of a broad spectrum of tachyarrhythmias. Previous studies also focused on catheter ablation of atrial fibrillation without fluoroscopy, [23][24][25][26] demonstrating safety, feasibility, and effectiveness of minimal fluoroscopic ablation in this patient population; however, we did not consider patients with atrial fibrillation in this population.…”

Section: Main Findingssupporting

confidence: 91%

Near-zero x-ray in arrhythmia ablation using a 3-dimensional electroanatomic mapping system: A multicenter experience

et al. 2016

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Section: Main Findingssupporting

confidence: 91%

Near-zero x-ray in arrhythmia ablation using a 3-dimensional electroanatomic mapping system: A multicenter experience

et al. 2016

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“…The techniques of catheter introduction, mapping, and ablation were carried out according to the established criteria. [15] The 2 patients were able to lie down for the time required to complete the procedure. Catheter ablation guided by Ensite NavX system and without fluoroscopy was performed on 2 pregnant women.…”

Section: Resultsmentioning

confidence: 99%

Zero-fluoroscopy catheter ablation of severe drug-resistant arrhythmia guided by Ensite NavX system during pregnancy

Chen

Sun

et al. 2016

Medicine

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Background:Cardiac arrhythmias can occur during pregnancy. Owing to radiation exposure and other uncertain risks for the mother and fetus, catheter ablation has rarely been performed and is often delayed until the postpartum period. We reported 2 pregnant women who were experiencing severe arrhythmias and were successfully ablated without fluoroscopic guidance. We also carried out a literature review of cases of pregnant women who underwent zero-fluoroscopy ablation.Methods and Results:One woman had drug-resistant and poorly tolerated frequent premature ventricular contraction (PVC) and ventricular tachycardia (VT). The other one had persistent and hardly terminated supraventricular tachycardia (SVT) via a right accessory pathway. The 2 patients were successfully underwent zero-fluoroscopy ablation guided by Ensite NavX system. The procedure time was 42 and 71 minutes, respectively.Conclusion:Catheter ablation of SVT or PVC/VT in pregnant patients can be safely and effectively performed with a completely zero-fluoroscopy approach guided by the Ensite NavX system. In the case of a drug refractory, life-threatening arrhythmia during pregnancy, catheter ablation may be considered.

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“…The feasibility of fluoroscopy-free mapping and ablation in the LA (after fluoroscopically-guided transseptal puncture) using the latest generation EAM system has recently been reported. 3 At the same time, a zero-fluoroscopy approach has been reported for arrhythmias originating in the RA using EAM systems [ 13 , 14 ]. Our study is the first report of a completely fluoroscopy-free PVI without additional technical equipment such as peri-procedural intracardiac or transesophageal echocardiography.…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopy-Free Pulmonary Vein Isolation in Patients with Atrial Fibrillation and a Patent Foramen Ovale Using Solely an Electroanatomic Mapping System

et al. 2016

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IntroductionThe advent of electroanatomical mapping (EAM) systems for pulmonary vein isolation (PVI) has dramatically decreased radiation exposure. However, the need for some fluoroscopy remains for obtaining left atrial (LA) access. The aim was to test the feasibility of fluoroscopy-free PVI in patients with atrial fibrillation (AF) and a patent foramen ovale (PFO) guided solely by an EAM system.MethodsConsecutive patients with AF undergoing PVI and documented PFO were studied. An EAM-guided approach without fluoroscopy and ultrasound was used. After completing the map of the right atrium, the superior vena cava and the coronary sinus, a catheter pull-down to the PFO was performed allowing LA access. The map of the LA and subsequent PVI was also performed without fluoroscopy.Results30 patients [age 61±12 years, 73% male, ejection fraction 0.64 (0.53–0.65), LA size in parasternal long axis 38±7 mm] undergoing PVI were included. The time required for right atrial mapping including transseptal crossing was 9±4 minutes. Total procedure time was 127±37 minutes. Fluoroscopy-free PVI was feasible in 26/30 (87%) patients. In four patients, fluoroscopy was needed to access (n = 3) or to re-access (n = 1) the LA. In these four patients, total fluoroscopy time was 5±3 min and the DAP was 14.9±13.4 Gy*cm2. Single-procedure success rate was 80% (24/30) after a median follow-up of 12 months.ConclusionIn patients with a documented PFO, completely fluoroscopy-free PVI is feasible in the vast majority of cases.

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A Zero‐Fluoroscopy Approach to Cavotricuspid Isthmus Catheter Ablation: Comparative Analysis of Two Electroanatomical Mapping Systems

Abstract: A zero-fluoroscopy approach to cavotricuspid isthmus catheter ablation using the Carto®3 system is feasible in most procedures. This approach has similar results to the zero-fluoroscopy approach using the Ensite-NavX™ system.

Cited by 30 publications

References 28 publications

Near-zero x-ray in arrhythmia ablation using a 3-dimensional electroanatomic mapping system: A multicenter experience

Near-zero x-ray in arrhythmia ablation using a 3-dimensional electroanatomic mapping system: A multicenter experience

Zero-fluoroscopy catheter ablation of severe drug-resistant arrhythmia guided by Ensite NavX system during pregnancy

Fluoroscopy-Free Pulmonary Vein Isolation in Patients with Atrial Fibrillation and a Patent Foramen Ovale Using Solely an Electroanatomic Mapping System

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