Single center experience of fluoroless AVNRT ablation guided by electroanatomic reconstruction in children and adolescents

Abstract

Background. Anatomical considerations and risks related to x-ray exposure make atrio-

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

“…With the accuracy offered by this modality, it should be a natural progression towards minimizing/completely eliminating fluoroscopy from most cardiac ablation procedures. 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.…”

“…4 Despite the advent of, and great improvement in, electroanatomic mapping (EAM) techniques over the last 20 years, fluoroscopy continues to be the primary imaging modality for intracardiac ablation procedures in the adult patient, although fluoroless (no fluoroscopy) ablation is being practiced in the pediatric population. 5 The ALARA (as low as reasonably achievable) principle maintains that there is no measurable lower safe dose for radiation, and encourages ''every reasonable effort to maintain exposures to ionizing radiation as far below the dose limits as practical.'' 6 There have been some reports and case series of both simple and complex arrhythmias in adults being performed without fluoroscopy, mostly using a combination of three-dimensional EAM techniques, intracardiac echocardiogram (ICE), and remote magnetic navigation systems.…”