Premium
Reduction of Radiation Exposure in Atrial Fibrillation Ablation Using a New Image Integration Module: A Prospective Randomized Trial in Patients Undergoing Pulmonary Vein Isolation
Author(s) -
AKBULAK RUKEN ÖZGE,
SCHÄFFER BENJAMIN,
JULARIC MARIO,
MOSER JULIA,
SCHREIBER DOREEN,
SALZBRUNN TIM,
MEYER CHRISTIAN,
EICKHOLT CHRISTIAN,
KUKLIK PAWEL,
HOFFMANN BORIS A.,
WILLEMS STEPHAN
Publication year - 2015
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12673
Subject(s) - medicine , fluoroscopy , atrial fibrillation , ablation , pulmonary vein , randomized controlled trial , catheter ablation , nuclear medicine , radiology , clinical endpoint
Reduced Radiation Exposure in AF Ablation Introduction Recently, a new image integration module (IIM, CartoUnivu™ Module) has been introduced to combine and merge fluoroscopy images with 3‐dimensional‐(3D)‐electroanatomical maps (Carto® 3 System) into an accurate 3D view. The aim of the study was to investigate the influence of IIM on the fluoroscopy exposure during pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) in a prospective randomized trial. Methods and results Between June and November 2014, a total of 60 patients with PAF (73.3% male, 64.0 ± 9.2 years), who underwent PVI with the endpoint of unexcitability of the ablation line, were randomized to either a conventional 3D mapping system (Carto® 3 System) or to an additional IIM on the basis of an assumed reduction of fluoroscopy exposure by the use of IIM. There were no significant differences in baseline characteristics. The median ablation procedure time was identical in both groups (140.7 ± 27.8 minutes vs. 140.8 ± 39.5 minutes; P = 0.851). A significant decrease of mean fluoroscopy time from 11.9 ± 2.1 to 7.4 ± 2.6 minutes (P < 0.0006) and median fluoroscopy dose from 882.9 to 476.5 cGycm 2 (P < 0.001) was achieved. The main reduction of radiation could be realized during creation of the 3D‐map. No major complications occurred during the procedures. After a median follow‐up of 125.7 ± 45.6 days 80% of the patients were free from any atrial arrhythmias. Conclusion CartoUnivu™ module easily integrates into the workflow of PVI with the endpoint of unexcitability of the ablation line without prolonging the procedure time. It is associated with a marked reduction in fluoroscopic dose when compared to a conventional 3D mapping system.