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Use of 3D Electroanatomical Navigation (CARTO‐3) to Minimize or Eliminate Fluoroscopy Use in the Ablation of Pediatric Supraventricular Tachyarrhythmias
Author(s) -
NAGARAJU LAKSHMI,
ME DIPIKA,
AZIZ PETER F.
Publication year - 2016
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/pace.12830
Subject(s) - medicine , fluoroscopy , supraventricular tachycardia , ablation , catheter ablation , catheter , radiation exposure , nuclear medicine , radiology , tachycardia
Background Radiation exposure related to medical procedures carries known medical risk. Electrophysiology (EP) and catheter ablation procedures are traditionally performed under fluoroscopic guidance. Three‐dimensional (3D) electroanatomical navigation systems decrease or eliminate fluoroscopy use in EP procedures. Objective The aim of this study was to assess the efficacy and outcome of a minimal or no fluoroscopic electroanatomical mapping approach for catheter ablations for supraventricular tachycardia (SVT) in the pediatric population. Methods Patients were identified through our EP database. A retrospective chart review was performed at a single institution. Results Sixty‐three pediatric patients underwent catheter ablations with a minimal fluoroscopic and 3D electroanatomical mapping using CARTO‐3 system (Biosense Webster, Diamond Bar, CA, USA) between October 2012 and March 2015. We selected 20 age‐matched patients who underwent ablations for SVT by the same operator prior to October 2012 with fluoroscopy use as our control group. The mean age in the study and control group was 13.9 years and 13.7 years, respectively. Mean procedure time was 208.7 minutes and 217.2 minutes in the study and control group (P = NS). Thirty‐four (54%) in the study group had no fluoroscopy use. Mean fluoroscopy time was 4.1 minutes versus 35.4 minutes between the study and the control group (P < 0.001). Radiation dose was 6.7 mGy versus 209.3 mGy between the study and the control group (P < 0.001). Acute procedural success was achieved in 95% and 90% of patients in the study and control groups, respectively. On follow‐up, the recurrence rate was 5.3% in the study group and 5.6% in the control group. Conclusion Catheter ablation for SVT in children can be successfully performed in patients with normal cardiac anatomy using minimal or no fluoroscopy with favorable outcomes.