Fluoroless catheter ablation of cardiac arrhythmia: Is it ready for prime time?

Razminia, Mansour; D’Silva, Oliver

doi:10.1111/pace.13840

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…All the tools needed for a successful radiation-free ablation are already available in most EP labs and familiar to most EP physicians. 24 Engagement in this field only needs a motivated team with a change in mindset. Once one does it, there is no way back.…”

Section: Discussionmentioning

confidence: 99%

Ablação Por Cateter Sem Uso de Fluoroscopia Para Tratamento de Fibrilação Atrial e Arritmias Atriais: Eficácia e Segurança

Saad¹,

Slater²,

Inácio³

et al. 2020

Arquivos Brasileiros De Cardiologia

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Background: The use of ionizing radiation in medical procedures is associated with significant health risks for patients and the health care team. Objectives: Evaluate the safety and acute efficacy of ablation for atrial fibrillation (AF) and supraventricular arrhythmias (SVTs) using an exclusively non-fluoroscopic approach guided by intracardiac echo (ICE) and 3D-mapping. Methods: 95 pts (mean age 60 ± 18 years, 61% male) scheduled for AF Ablation (69 pts, 45 paroxysmal AF and 24 persistent AF) or non-AF SVT (26 pts-14 AV node reentry, 6 WPW, 5 right atrial (RA) flutters, 1 atrial tachycardia) underwent zero fluoro procedures. Nine patients (9.5%) had permanent pacemakers or defibrillator resynchronization (CRT-D) devices. Both CARTO (65%) and NAVx (35%) mapping systems were used, as well as Acunav and ViewFlex ICE catheters. Results: Pulmonary vein isolation (PVI), as well as all other targets that needed ablation in both atria were reached and adequately visualized. No pericardial effusions, thrombotic complications or other difficulties were seen in these series. Difficult transseptal puncture (19 patients-20%) was managed without fluoroscopy in all cases. No backup fluoroscopy was used, and no lead apparel was needed. Pacemaker interrogations after the procedure did not show any lead damage, dislocation, or threshold changes. Conclusions: A radiation-free (fluoroless) catheter ablation strategy for AF and other atrial arrhythmias is acutely safe and effective when guided by adequate ICE and 3D-mapping utilization. Multiple different bi-atrial sites were reached and adequately ablated without the need for backup fluoroscopy. No complications were seen.

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Section: Discussionmentioning

confidence: 99%

Ablação Por Cateter Sem Uso de Fluoroscopia Para Tratamento de Fibrilação Atrial e Arritmias Atriais: Eficácia e Segurança

Saad¹,

Slater²,

Inácio³

et al. 2020

Arquivos Brasileiros De Cardiologia

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Deep Learning-Based Electrocardiograph in Evaluating Radiofrequency Ablation for Rapid Arrhythmia

Wang¹,

Chen²,

Xue-qin³

et al. 2022

Computational and Mathematical Methods in Medicine

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This study is aimed at analyzing the important role of deep learning-based electrocardiograph (ECG) in the efficacy evaluation of radiofrequency ablation in the treatment of tachyarrhythmia. In this study, 158 patients with rapid arrhythmia treated by radiofrequency ablation were divided into effective treatment group (142 cases) and ineffective treatment group (16 cases). ECG examination was performed on all patients, and the indicators of ECG examination were quantified by the deep learning-based convolutional neural network model. The indicators of ECG examination of the effective treatment group and the ineffective treatment group were compared. The results showed that compared with the ineffective treatment group, the end-systolic volume (ESV), end-diastolic volume (EDV), end-systolic volume index (ESVI), and end-diastolic volume index (EDVI) of the effective treatment group were significantly decreased, and the left ventricular ejection fraction (LVEF) was significantly increased ( P < 0.05 ). After radiofrequency ablation, the ventricular rate of patients in the effective treatment group was significantly lower than that of the ineffective treatment group at 12 h and 24 h after treatment ( P < 0.05 ). In addition, compared with patients in the ineffective treatment group, the QT dispersion of the ECG in the effective treatment group was significantly higher ( P < 0.05 ). The accuracy, specificity, and sensitivity of ECG in evaluating the therapeutic effect of patients with tachyarrhythmia were 86.81%, 84.29%, and 77.27%, respectively. The area under the curve was determined as 0.798 according to the receiver operating characteristic (ROC) curve of the subjects. In summary, indicators of ECG examination based on deep learning can provide auxiliary reference information for the efficacy evaluation of radiofrequency ablation in the treatment of tachyarrhythmia.

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Fluoroless catheter ablation of cardiac arrhythmia: Is it ready for prime time?

Cited by 2 publications

References 15 publications

Ablação Por Cateter Sem Uso de Fluoroscopia Para Tratamento de Fibrilação Atrial e Arritmias Atriais: Eficácia e Segurança

Ablação Por Cateter Sem Uso de Fluoroscopia Para Tratamento de Fibrilação Atrial e Arritmias Atriais: Eficácia e Segurança

Deep Learning-Based Electrocardiograph in Evaluating Radiofrequency Ablation for Rapid Arrhythmia

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