Comparison of minimal versus zero-fluoroscopic catheter ablation in gestational supraventricular arrhythmias

You, Joseph; Pagan, Eric; Mitra, Raman

doi:10.1007/s10840-022-01444-1

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…In these cases, antiarrhythmic drugs may be effective but at costs of risk for the fetus [66], equal to radiation exposure. In these cases, fluoroless or minimal radiation exposure CA is considered mandatory [67,68], as reported in the latest guidelines with a recommendation level IIa and IIb, respectively [55,56]. Minimizing radiation exposure is also of paramount importance in the pediatric population to reduce long-term consequences [69,70].…”

Section: Paroxysmal Supraventricular Tachycardiasmentioning

confidence: 99%

The Fluoroless Future in Electrophysiology: A State-of-the-Art Review

Preda,

Bonvicini,

Coradello

et al. 2024

Diagnostics

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Fluoroscopy has always been the cornerstone imaging method of interventional cardiology procedures. However, radiation exposure is linked to an increased risk of malignancies and multiorgan diseases. The medical team is even more exposed to X-rays, and a higher incidence of malignancies was reported in this professional group. In the last years, X-ray exposure has increased rapidly, involving, above all, the medical team and young patients and forcing alternative fluoroless imaging methods. In cardiac electrophysiology (EP) and pacing, the advent of 3D electroanatomic mapping systems with dedicated catheters has allowed real-time, high-density reconstruction of both heart anatomy and electrical activity, significantly reducing the use of fluoroscopy. In addition, the diffusion of intracardiac echocardiography has provided high anatomical resolution of moving cardiac structures, providing intraprocedural guidance for more complex catheter ablation procedures. These methods have largely demonstrated safety and effectiveness, allowing for a dramatic reduction in X-ray delivery in most arrhythmias’ ablations. However, some technical concerns, as well as higher costs, currently do not allow their spread out in EP labs and limit their use to only procedures that are considered highly complex and time-consuming and in young patients. In this review, we aim to update the current employment of fluoroless imaging in different EP procedures, focusing on its strengths and weaknesses.

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