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Effective reduction of fluoroscopy duration by using an advanced electroanatomic-mapping system and a standardized procedural protocol for ablation of atrial fibrillation: ‘the unleaded study'

Knecht, Sven ; Sticherling, Christian ; Reichlin, Tobias ; Pavlovic, Nikola ; Mühl, Aline ; Schaer, Beat ; Osswald, Stefan ; Kühne, Michael

In: EP Europace, 2015, vol. 17, no. 11, p. 1694-1699

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    Titre
    • Effective reduction of fluoroscopy duration by using an advanced electroanatomic-mapping system and a standardized procedural protocol for ablation of atrial fibrillation: ‘the unleaded study'
    Auteur
    • Knecht, Sven. Department of Cardiology, University Hospital Basel, Basel, Switzerland
    • Sticherling, Christian. Department of Cardiology, University Hospital Basel, Basel, Switzerland
    • Reichlin, Tobias. Department of Cardiology, University Hospital Basel, Basel, Switzerland
    • Pavlovic, Nikola. Department of Cardiology, University Hospital Basel, Basel, Switzerland
    • Mühl, Aline. Department of Cardiology, University Hospital Basel, Basel, Switzerland
    • Schaer, Beat. Department of Cardiology, University Hospital Basel, Basel, Switzerland
    • Osswald, Stefan. Department of Cardiology, University Hospital Basel, Basel, Switzerland
    • Kühne, Michael. Department of Cardiology, University Hospital Basel, Basel, Switzerland
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • EP Europace, 2015, vol. 17, no. 11, p. 1694-1699. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:293819
    Summary
    Aims It is recommended to keep exposure to ionizing radiation as low as reasonably achievable. The aim of this study was to determine whether fluoroscopy-free mapping and ablation using a standardized procedural protocol is feasible in patients undergoing pulmonary vein isolation (PVI). Methods and results Sixty consecutive patients were analysed: Thirty consecutive patients undergoing PVI using Carto3 were treated using a standardized procedural fluoroscopy protocol with X-ray being disabled after transseptal puncture (Group 1) and compared with a set of previous 30 consecutive patients undergoing PVI without a specific recommendation regarding the use of fluoroscopy (Group 2). The main outcome measures were the feasibility of fluoroscopy-free mapping and ablation, total fluoroscopy time, total dose area product (DAP), and procedure time. Sixty patients (age 60 ± 10 years, 73% male, ejection fraction 0.55 ± 0.09, left atrium 42 ± 8 mm) were included. In Group 1, total fluoroscopy time was 4.2 (2.6-5.6) min and mapping and ablation during PVI without using fluoroscopy was feasible in 29 of 30 patients (97%). In Group 2, total fluoroscopy time was 9.3 (6.4-13.9) min (P < 0.001). Total DAP was 13.2 (6.2-22.2) Gy*cm2 in Group 1 compared with 17.5 (11.7-29.7) Gy*cm2 in Group 2 (P = 0.036). Total procedure time did not differ between Groups 1 (133 ± 37 min) and 2 (134 ± 37 min, P = 0.884). Conclusion Performing mapping and ablation guided by an electroanatomic-mapping system during PVI without using fluoroscopy after transseptal puncture using a standardized procedural protocol is feasible in almost all patients and is associated with markedly decreased total fluoroscopy duration and DAP