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Elimination of Fluoroscopy Use in a Pediatric Electrophysiology Laboratory Utilizing Three‐Dimensional Mapping
Author(s) -
SMITH GRACE,
CLARK JOHN M.
Publication year - 2007
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.1540-8159.2007.00701.x
Subject(s) - fluoroscopy , medicine , supraventricular tachycardia , ablation , catheter , catheter ablation , tachycardia , radiology , nuclear medicine
Objectives: The aim of this study was to quantify fluoroscopy use in catheter ablation procedures using a three‐dimensional mapping system as the primary source of catheter guidance.Background: Three‐dimensional mapping allows continuous visualization of the location of mapping and ablation catheter electrodes. It has been shown to decrease fluoroscopy times. However, the extent to which it can decrease fluoroscopy time has not been completely defined.Methods: Thirty patients (mean age 12.9 years; range 4–27 years) with reentrant supraventricular tachycardia underwent catheter ablation using standard protocols. Mapping was performed using the EnSite system (St. Jude Medical, St Paul, MN, USA) in the NavX mode (NavX). Eighteen patients had AVNRT, 12 had AVRT. Fluoroscopy times were compared to an age‐matched and rhythm‐matched control population.Results: Procedural success was achieved in 30 of 30 patients (100%). Mean procedure time was 3.27 hours (range 1.83–5.8 hours). Mean fluoroscopy time was 1.05 minutes (range 0–14.8 minutes). Twenty‐four of 30 (80%) received no fluoroscopy. Mean fluoroscopy time for the control group was 21.37 minutes (range 5.13–77.13 minutes). Thus fluoroscopy time was 95% less in the study group compared to control (1.05 ± 2.96 vs 21.37 ± 18.35 minutes, P < 0.001).Conclusions: NavX was used to effectively guide catheters during ablation procedures resulting in a significant decrease in fluoroscopy use. In 80% of the procedures, no fluoroscopy was used. Further advances in the technology may permit additional decreases in x‐ray exposure for the 20% of patients who required it.