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- Title
Evaluation of a near-zero fluoroscopic approach for catheter ablation in patients with congenital heart disease.
- Authors
Cano, Óscar; Saurí, Assumpció; Plaza, Diego; Osca, Joaquín; Sancho-Tello, María-José; Rueda, Joaquín; Osa, Ana; Martínez-Dolz, Luis
- Abstract
<bold>Purpose: </bold>Radiation exposure (RE) is a matter of concern for patients with congenital heart disease (CHD) who not infrequently need multiple interventional procedures under fluoroscopy guidance. We sought to evaluate the safety and feasibility of a minimally fluoroscopic approach in patients with CHD undergoing catheter ablation using a new image integration module (IIM).<bold>Methods: </bold>Consecutive patients with CHD undergoing catheter ablation using the Carto Univu™ IIM were included. A near-zero fluoroscopy procedure was defined by an effective dose (ED) ≤ 1 mSv. RE parameters (total fluoroscopy time [TFT], total dose area product [tDAP], and ED), ablation outcomes, and complications were evaluated.<bold>Results: </bold>Fifty-five patients with CHD underwent 63 ablation procedures (supraventricular tachycardia, n = 53; ventricular tachycardia, n = 10). The CHD was simple in 25%, moderate in 42%, and complex in 33%. The use of the IIM resulted in very low levels of RE (median TFT 0.13 min [IQR 0-1.04], median tDAP 54.5 cGy cm2 [IQR 9.5-176.4], median ED 0.136 mSv [IQR 0.02-0.49]). Patients with complex CHD had significantly higher RE when compared with patients with simple and moderate defects. A total of 56/63 ablation procedures (89%) were performed with an ED ≤ 1 mSv. One patient developed sinus node dysfunction requiring pacemaker implantation.<bold>Conclusions: </bold>The use of a minimally fluoroscopic approach was safe and feasible resulting in very low RE during catheter ablation of patients with CHD. A near-zero fluoroscopy ablation was possible in up to 89% of the procedures.
- Subjects
CONGENITAL heart disease; CATHETER ablation; CARDIAC patients; CARDIAC pacemakers; SUPRAVENTRICULAR tachycardia; VENTRICULAR tachycardia; FLUOROSCOPY; HEART function tests; PILOT projects
- Publication
Journal of Interventional Cardiac Electrophysiology, 2019, Vol 56, Issue 3, p259
- ISSN
1383-875X
- Publication type
journal article
- DOI
10.1007/s10840-018-0467-3