Chinese expert consensus on the construction of the fluoroless cardiac electrophysiology laboratory and related techniques

Abstract

Transcatheter radiofrequency ablation has been widely introduced for the treatment of tachyarrhythmias. The demand for catheter ablation continues to grow rapidly as the level of recommendation for catheter ablation. Traditional catheter ablation is performed under the guidance of X‐rays. X‐rays can help display the heart contour and catheter position, but the radiobiological effects caused by ionizing radiation and the occupational injuries worn caused by medical staff wearing heavy protective equipment cannot be ignored. Three‐dimensional mapping system and intracardiac echocardiography can provide detailed anatomical and electrical information during cardiac electrophysiological study and ablation procedure, and can also greatly reduce or avoid the use of X‐rays. In recent years, fluoroless catheter ablation technique has been well demonstrated for most arrhythmic diseases. Several centers have reported performing procedures in a purposefully designed fluoroless electrophysiology catheterization laboratory (EP Lab) without fixed digital subtraction angiography equipment. In view of the lack of relevant standardized configurations and operating procedures, this expert task force has written this consensus statement in combination with relevant research and experience from China and abroad, with the aim of providing guidance for hospitals (institutions) and physicians intending to build a fluoroless cardiac EP Lab, implement relevant technologies, promote the standardized construction of the fluoroless cardiac EP Lab.

Clinical outcomes of radiofrequency catheter ablation guided by intracardiac echocardiography for Chinese atrial fibrillation patients: a single-center, retrospective study

“…The exposure to ionizing radiation leading to complications such as skin damage, cancer, radiation-induced cataracts, and genetic mutations has remained a challenge in clinical practice. The use of ICE enables fluoroscopy-free procedures, avoiding prolonged exposure of procedural operators to radiation and offering a safer option for patients, especially for pregnant women and children ( 15 ). Moreover, it helps prevent interventional medical staff from experiencing occupational musculoskeletal conditions associated with wearing the radiation blocking equipment, thereby reducing problems like neck and back pain, severe disc herniation, ultimately enhancing the physical and mental well-being of healthcare professionals and extending their careers ( 16 ).…”

“…ICE technology’s real-time imaging, continual ablation catheter tracking, and intraoperative complication monitoring significantly enhance usability, especially for beginners ( 15 ). Study by Zei et al highlights that employing an ICE-based approach in AF catheter ablation substantially reduces the learning curve for beginners ( 17 ).…”