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A New Nonfluoroscopic Navigation System to Guide Pulmonary Vein Isolation
Author(s) -
TONDO CLAUDIO,
MANTICA MASSIMO,
RUSSO GIOVANNI,
KARAPATSOUDI ELENI,
LUCCHINA ARIANNA,
NIGRO FRANCO,
WILD MICHAELA,
MOLINARO CRISTINA,
BAVILA ROBERTO
Publication year - 2005
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2005.00047.x
Subject(s) - medicine , fluoroscopy , pulmonary vein , ablation , atrial fibrillation , catheter ablation , radiofrequency ablation , left atrium , ablation of atrial fibrillation , nuclear medicine , radiology
Different techniques have been proposed to treat atrial fibrillation (AF) by catheter ablation. This study compares a new three‐dimensional (3D) nonfluoroscopic navigation system with conventional fluoroscopy to guide pulmonary vein (PV) isolation. A total of 60 consecutive patients with paroxysmal or persistent AF were randomly assigned to 3D‐guided ablation (group 1, n = 30), versus conventional fluoroscopy guidance ablation (group 2, n = 30). Complete PV isolation was achieved in both groups. The mean duration of fluoroscopy exposure (22 ± 8 vs 56 ± 10 minutes), and radiofrequency delivery (5 ± 1 vs 10 ± 3 minutes) were significantly shorter in group 1 than in group 2, P < 0.05 for both comparisons). The mean procedural time in group 1 was longer (225 ± 15 minutes) than in group 2 (156 ± 10 minutes, P < 0.05) due to the learning curve and time spent to generate the 3D maps. Over a mean follow‐up of 7 ± 2 months, 6 patients (20%) in group 2 had AF recurrences compared to 3 patients (10%) in group 1 (ns). The new nonfluoroscopic 3D system allows a high‐resolution reconstruction of the left atrium and PVs. It significantly reduces the mean radiofrequency delivery and fluoroscopy times as opposed to ablation performed under fluoroscopy guidance.