Long-term outcomes after “Zero X-ray” arrhythmia ablation

Giaccardi, Marzia; Mascia, Giuseppe; Perini, Alessandro Paoletti; Giomi, Andrea; Cartei, Stella; Milli, Massimo

doi:10.1007/s10840-018-0390-7

Cited by 26 publications

(30 citation statements)

References 31 publications

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“…En la FA, la tasa de empleo casi coincide, con el 99% de las ablaciones realizadas con radiofrecuencia, y superan el 90% en las ablaciones de TV con cardiopatía. El uso del navegador permite seguir avanzando en el objetivo de «escopia 0», especialmente a medida que se confirman su seguridad y su eficacia 27 . Este año los procedimientos sin apoyo de fluoroscopia han doblado la cifra de 2018 hasta el 11% de todos los casos comunicados en el registro actual.…”

Section: Discussionunclassified

Registro Español de Ablación con Catéter. XIX Informe Oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2019)

Quesada

León

Anguera

2020

Revista Española de Cardiología

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Introducción y objetivos Se describen los resultados del Registro Español de Ablación correspondientes al año 2019. Métodos La recogida de datos ha sido retrospectiva mediante la cumplimentación de un formulario de recogida de datos por cada uno de los centros participantes. Resultados Se han analizado los datos enviados por 102 centros, con un total de 18.549 procedimientos de ablación (el mayor de este registro) y con una media de 181,9 ± 137,0 y una mediana de 144,5 procedimientos por centro. Se consolida la ablación de fibrilación auricular como el sustrato abordado con más frecuencia (n = 5.164; 27,8%), que aumenta la distancia respecto al resto de sustratos. El segundo sustrato es el istmo cavotricuspídeo (n = 3.925; 21,1%) y el tercero, la taquicardia por reentrada intranodular (n = 3.768; 20,3%), desbancada del segundo puesto por aquel. La tasa total de éxito fue de nuevo del 91%; la de complicaciones mayores, del 1,9% y la mortalidad, del 0,03%. Se consolida el uso de navegadores (el 44,5% del total de procedimientos) y de los catéteres con tecnología de contacto en la fibrilación auricular (84,8%) y la taquicardia ventricular (90%). El 1,5% de las ablaciones se realizaron en pacientes pediátricos. Conclusiones El Registro Español de Ablación recoge de manera sistemática sin interrupción los procedimientos de ablación realizados en España, y permite observar a lo largo de los años un aumento progresivo del número de ablaciones manteniendo una alta tasa de éxito y unos porcentajes bajos de complicaciones.

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Section: Discussionunclassified

Registro Español de Ablación con Catéter. XIX Informe Oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2019)

Quesada

León

Anguera

2020

Revista Española de Cardiología

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“…Nonfluoroscopic ablation (NFA) of arrhythmias has been described and shown to be safe in the ablation of supraventricular tachycardia (SVT) and typical atrial flutter . There are reports on using NFA in paroxysmal atrial fibrillation (AF) and outflow‐tract ventricular arrhythmia (VA) ablation; however, some patients required rescue fluoroscopy .…”

Section: Introductionmentioning

confidence: 99%

Completely nonfluoroscopic catheter ablation of left atrial arrhythmias and ventricular tachycardia

Sadek

Ramirez

Nery

et al. 2018

Cardiovasc electrophysiol

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“…Over the years advances in equipment and application of radiation safety protocols have significantly reduced patient dose and operator exposure. Nowadays it is possible to safely and efficiently perform zero X‐ray arrhythmia ablation thanks to mapping system 11 . However, the high dose of fluoroscopy required during HBP is until now an unresolved pitfall.…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays it is possible to safely and efficiently perform zero X-ray arrhythmia ablation thanks to mapping system. 11 [15][16][17][18][19] The time spent to localize the His bundle and fix up the lead represents one of the main technical concern, and was thought to result in a prolonged procedure with high FT. In a series of lower FT in patients with successful HBP compared with those subjects with unsuccessful HBP (10 ± 7 vs 24 ± 1 minutes, respectively).…”

Section: Discussionmentioning

confidence: 99%

Electrogram‐only guided approach to His bundle pacing with minimal fluoroscopy: A single‐center experience

Zanon

Marcantoni

Zuin

et al. 2020

Cardiovasc electrophysiol

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Introduction His bundle pacing (HBP) is the most physiological pacing. The standard technique based on fluoroscopic approach might be challenging and fluoro consuming. Targeting the His guided exclusively by the electrical signals could enable a precise lead implant, thus reducing fluoroscopy time (FT) and X‐ray dose, desirable both for patients and operators. The aim of the study is to evaluate the feasibility, efficacy, and safety both acutely and at 30 days of the electrogram (EGM)‐guided HBP with minimal or no fluoroscopy. Methods and Results Between October and December 2018, 41 consecutive patients underwent EGM‐guided HBP. Successful HBP was obtained in 39 (95%) patients, (30 males, 78 ± 10 years). Selective HBP (S‐HBP) was achieved in 23 (59%), nonselective HBP (NS‐HBP) in 16 (41%) patients. The final HBP lead position was reached in 31 (79.4%) patients without fluoroscopy, only guided by electrical signals. In eight patients a minimal fluoroscopy (mean, 8 seconds) has been required. The sheath's cutting and the slack of the lead were routinely performed under fluoroscopy. No difference was observed in FT for HBP lead placement in S‐HBP and NS‐HBP (mean, 8.1 ± 25 vs 7.5 ± 20 seconds, P = .8; median value 0 vs 0 seconds). No differences were observed in FT for the entire procedure, total dose area product and total procedural time in S‐HBP and NS‐HBP. Lead dislodgement occurred in one (2.6%) patient 1 day after the procedure. Conclusions HBP could be performed safely and efficiently using the EGMs, with minimal or no fluoroscopy. Fluoroscopy was required during sheath removal and atrial lead placement.

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Long-term outcomes after “Zero X-ray” arrhythmia ablation

Cited by 26 publications

References 31 publications

Registro Español de Ablación con Catéter. XIX Informe Oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2019)

Registro Español de Ablación con Catéter. XIX Informe Oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2019)

Completely nonfluoroscopic catheter ablation of left atrial arrhythmias and ventricular tachycardia

Electrogram‐only guided approach to His bundle pacing with minimal fluoroscopy: A single‐center experience

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