Completely nonfluoroscopic catheter ablation of left atrial arrhythmias and ventricular tachycardia

Sadek, Mouhannad M.; Ramirez, F. Daniel; Nery, Pablo B.; Golian, Mehrdad; Redpath, Calum J.; Nair, Girish M.; Birnie, David H.

doi:10.1111/jce.13735

Cited by 38 publications

(30 citation statements)

References 41 publications

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“…Sadek et al 55 more recently published their experience with a fluoroless approach in a relatively complex patient population including 70 complex left AT (33 with persistent AF and six with left AFL) and 10 VT (60% with scar-mediated VT) ablations performed using ICE and EAM guidance, which had a 100% acute success rate, similar procedural times as compared with when using fluoroscopic guidance, and no complications. Despite such a limitation, the authors added to the evidence regarding the feasibility of a fluoroless approach in complex cardiac arrhythmias, including a more complex atrial substrate and a higher burden of atrial scar, characteristics which require more extensive ablation as compared with standard pulmonary vein isolation.…”

Section: State Of Fluoroless Procedures For Atrial Fibrillationmentioning

confidence: 99%

“…The study included a total of 10 ablation procedures for VAs including VPCs and VTs with a mean procedure time of 150 minutes ± 45 minutes and no complications. Furthermore, Sadek et al 55 reported a total of 10 fluoroless VT ablations (60% involving scar-mediated VTs and 1% being ARVC-mediated) using ICE and three-dimensional EAM. All patients with outflow-tract VPCs demonstrated no recurrence during follow-up, and the treatment success rate was 83% in patients with scar-mediated VTs.…”

Section: State Of Fluoroless Procedures For Ventricular Arrhythmiasmentioning

confidence: 99%

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State of Fluoroless Procedures in Cardiac Electrophysiology Practice

Canpolat

Faggioni

Rocca

et al. 2020

J Innov Cardiac Rhythm Manage

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In the past decade, the use of interventional electrophysiological (EP) procedures for the diagnosis and treatment of cardiac arrhythmias has exponentially increased. These procedures usually require fluoroscopy to guide the advancement and frequent repositioning of intracardiac catheters, resulting in both the patient and the operator being subjected to a considerable degree of radiation exposure. Although shielding options such as lead gowns, glasses, and pull-down shields are useful for protecting the operator, they do not lessen the patient's level of exposure. Furthermore, the prolonged use of lead gowns can exponentiate the onset of orthopedic problems among operators. Recent advancements in three-dimensional cardiac mapping systems and the use of radiation-free imaging technologies such as magnetic resonance imaging and intracardiac ultrasound allow operators to perform EP procedures with minimal or even no fluoroscopy. In this review, we sought to describe the state of fluoroless procedures in EP practice.

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Section: State Of Fluoroless Procedures For Atrial Fibrillationmentioning

confidence: 99%

Section: State Of Fluoroless Procedures For Ventricular Arrhythmiasmentioning

confidence: 99%

State of Fluoroless Procedures in Cardiac Electrophysiology Practice

Canpolat

Faggioni

Rocca

et al. 2020

J Innov Cardiac Rhythm Manage

View full text Add to dashboard Cite

show abstract

“…There is an increasing recent focus on minimizing fluoroscopic exposure during ablation procedures. Sadek et al reported that nonfluoroscopic RA access can be performed safely using ICE guidance. It is important to note however that the report included only four patients undergoing retrograde access for scar‐related VT.…”

Section: Techniques For Ra Accessmentioning

confidence: 99%

Retrograde aortic access during ventricular tachycardia ablation: Indications, techniques, and challenges

Adlan

Campbell

Fairbairn

et al. 2019

Cardiovasc electrophysiol

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The retrograde aortic (RA) route is a widely used access route for mapping and ablation of ventricular tachycardias (VT) arising from the left ventricular endocardium. With the expanding role of VT ablation in patients with significant comorbidity, the choice between the RA and transseptal access routes is an increasingly important consideration. An individualized decision based on the location of the arrhythmogenic substrate, vascular anatomy, aortic valve morphology, and operator experience is necessary when deciding on the optimal access route. Among patients with challenging vascular anatomy, growing experience from structural interventions such as transcatheter aortic valve replacements and peripheral vascular interventions has provided valuable insights into techniques for safe retrograde access. The present review focuses on patient selection for RA access, potential complications associated with the technique, and optimal approaches for access in patients with challenging vascular or aortic valve anatomy.

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“…In 2010, Dr Vivek Reddy and colleagues gave a first report on catheter ablation of atrial fibrillation without fluoroscopy . Since then, there have been numerous studies reporting on the safety and efficacy of fluoroless catheter ablation for all arrhythmia types, including atrial fibrillation, atrial tachycardia, and ventricular tachycardia . It should be noted that special situations where a fluoroless technique would not be recommended as an initial approach involve epicardial ablation and in patients with complex congenital heart disease.…”

mentioning

confidence: 99%