Contact force–controlled zero-fluoroscopy catheter ablation of right-sided and left atrial arrhythmia substrates

Kerst, Gunter; Weig, Hans-Jörg; Weretka, Slawomir; Seizer, Peter; Hofbeck, Michael; Gawaz, Meinrad; Schreieck, Jüergen

doi:10.1016/j.hrthm.2011.12.025

Cited by 63 publications

(49 citation statements)

References 23 publications

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“…Kerst et al [19] showed in a group of 30 patients that contact force-controlled zero fluoroscopy catheter ablation is generally feasible in right-sided and left atrial cardiac arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of zero or near zero fluoroscopy during catheter ablation procedures

Haegeli

Stutz²,

Mohsen³

et al. 2019

Cardiol J

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Section: Discussionmentioning

confidence: 99%

Feasibility of zero or near zero fluoroscopy during catheter ablation procedures

Haegeli

Stutz²,

Mohsen³

et al. 2019

Cardiol J

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“…16,17) With contact force sensing technology, it is theoretically possible to reduce fluoroscopic exposure and to avoid excessively high and low contact force. 18) However, at this moment, electrophysiological procedures without radiation are not widely feasible, and safety issues have to be addressed.…”

Section: Discussionmentioning

confidence: 99%

Reduction of Fluoroscopic Exposure Using a New Fluoroscopy Integrating Technology in a 3D-Mapping System During Pulmonary Vein Isolation With a Circular Multipolar Irrigated Catheter

et al. 2016

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SummaryPulmonary vein isolation (PVI) is a cornerstone therapy in patients with atrial fibrillation (AF). With increasing numbers of PVI procedures, demand arises to reduce the cumulative fluoroscopic radiation exposure for both the physician and the patient. New technologies are emerging to address this issue. Here, we report our first experiences with a new fluoroscopy integrating technology in addition to a current 3D-mapping system. The new fluoroscopy integrating system (FIS) with 3D-mapping was used prospectively in 15 patients with AF. Control PVI cases (n = 37) were collected retrospectively as a complete series. Total procedure time (skin to skin), fluoroscopic time, and dose-area-product (DAP) data were analyzed. All PVI procedures were performed by one experienced physician using a commercially available circular multipolar irrigated ablation catheter. All PVI procedures were successfully undertaken without major complications. Baseline characteristics of the two groups showed no significant differences. In the group using the FIS, the fluoroscopic time and DAP were significantly reduced from 571 ± 187 seconds versus 1011 ± 527 seconds (P = 0.0029) and 4342 ± 2073 cGycm 2 versus 6208 ± 3314 cGycm 2 (P = 0.049), respectively. Mean procedure time was not significantly affected and was 114 ± 31 minutes versus 104 ± 24 minutes (P = 0.23) by the FIS.The use of the new FIS with the current 3D-mapping system enables a significant reduction of the total fluoroscopy time and DAP compared to the previous combination of 3D-mapping system plus normal fluoroscopy during PVI utilizing a circular multipolar irrigated ablation catheter. However, the concomitant total procedure time is not affected. Thus, the new system reduces the radiation exposure for both the physicians and patients. (Int Heart J 2016; 57: 299-303)

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“…However, although the use of fluoroless ablation of supraventricular arrhythmias is being aggressively pursued in the pediatric population, 5,[10][11][12][13] fluoroless ablation in the adult patient has been described in only a few studies from Europe, and with limited data from the United States. Kerst et al 14 presented an observational series of 30 patients, including 12 children, 29 of whom underwent successful fluoroless ablation for right and left atrial arrhythmias using a contact force-sensing catheter, and ICE imaging for CS cannulation. Razminia et al 15 performed a retrospective analysis comparing 60 patients with a variety of arrhythmias who underwent ablation without fluoroscopy with a matched group of patient who had previously undergone standard ablation utilizing fluoroscopy.…”

Section: Discussionmentioning

confidence: 99%

Fluoroless Radiofrequency Ablation of Typical Cavotricuspid Isthmus-dependent Atrial Flutter is a Safe and Practical Procedure

Gautam¹

2015

JICRM

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ABSTRACT. Electrophysiologic procedures, including radiofrequency ablation of cavotricuspid isthmus (CTI)-dependent atrial flutter, typically require varying amounts of fluoroscopy, which could be completely eliminated with electroanatomic mapping. We compared 20 consecutive patients who underwent fluoroless ablation for atrial flutter (Group A) with a prior series of 20 patients with standard flutter ablation (Group B). CARTO 3 mapping software was used to position diagnostic and ablation catheters in Group A; the ablation catheter was used to create a shell of the right atrium and coronary sinus (CS), and to guide CS catheter positioning. Atrial flutter was ablated successfully and bidirectional CTI block achieved without complication in all patients in both groups. Mean fluoroscopic duration and dose in Group B was 6.3 ± 3.3 min and 138±119 mGy respectively. There was no difference between Group A and Group B in procedure duration (110.2 ± 43.1 versus 114.9 ± 29.2 minutes, p ¼ 0.69), ablation duration (15.0 ± 11.7 versus 17.2 ± 10.1 min, p ¼ 0.52), time to ablation start (40.4 ± 13.3 versus 41.9 ± 14.8 min, p ¼ 0.74), and time from CS catheter insertion to optimal placement (5.4±4.4 versus 6.3±5.0 minutes, p ¼ 0.74). There was also no significant difference in these parameters between the first and last 10 patients in Group A. Fluoroless ablation for right atrial CTI-dependent flutter is safe and practical, with obvious advantages of avoidance of radiation exposure to patients and staff. Further studies are warranted applying these principles to other arrhythmia substrates.

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Contact force–controlled zero-fluoroscopy catheter ablation of right-sided and left atrial arrhythmia substrates

Cited by 63 publications

References 23 publications

Feasibility of zero or near zero fluoroscopy during catheter ablation procedures

Feasibility of zero or near zero fluoroscopy during catheter ablation procedures

Reduction of Fluoroscopic Exposure Using a New Fluoroscopy Integrating Technology in a 3D-Mapping System During Pulmonary Vein Isolation With a Circular Multipolar Irrigated Catheter

Fluoroless Radiofrequency Ablation of Typical Cavotricuspid Isthmus-dependent Atrial Flutter is a Safe and Practical Procedure

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