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Fluoroless Catheter Ablation of Cardiac Arrhythmias: A 5‐Year Experience
Author(s) -
RAZMINIA MANSOUR,
WILLOUGHBY MICHAEL CAMERON,
DEMO HANY,
KESHMIRI HESAM,
WANG THEODORE,
D'SILVA OLIVER J.,
ZHEUTLIN TERRY A.,
JIBAWI HAKEEM,
OKHUMALE PAUL,
KEHOE RICHARD F.
Publication year - 2017
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.13038
Subject(s) - medicine , fluoroscopy , tachycardia , catheter ablation , ablation , intracardiac injection , cardiology , atrial fibrillation , atrial tachycardia , catheter , atrioventricular reentrant tachycardia , radiofrequency ablation , ventricular tachycardia , radiology , accessory pathway
Background Catheter ablations have been traditionally performed with the use of fluoroscopic guidance, which exposes the patient and staff to the inherent risks of radiation. We have developed techniques to eliminate the use of fluoroscopy during cardiac ablations and have been performing completely fluoroless catheter ablations on our patients for over 5 years. Methods We present a retrospective analysis of the safety, efficacy, and feasibility data from 500 consecutive patients who underwent nonfluoroscopic catheter ablation, targeting a total of 639 arrhythmias, including atrioventricular reciprocating tachycardia (AVRT), atrioventricular nodal reentrant tachycardia (AVNRT), atrial tachycardia (AT), atrial fibrillation (AF), premature ventricular contractions (PVCs), and ventricular tachycardia (VT). We perform fluoroless ablations using intracardiac electrograms, electroanatomic mapping, and for most cases intracardiac echocardiography. Our experience includes exclusively endocardial cardiac ablations. Results The mean follow‐up was 20.5 months. Recurrence rate for AVRT was 6.5%, for AVNRT 2.5%, for macro‐reentrant AT 6.4%, for focal AT 5.4%, for AF 22.6%, for PVC 6.7%, and for VT 21.4%. Major complications occurred in five patients (1.0%); minor complications occurred in three patients (0.6%). No deaths occurred. Fluoroscopy was used in one instance, for 0.3 minutes, to confirm venous access. Conclusions Completely fluoroless catheter ablations may be routinely performed for all endocardial ablations without compromising safety, efficacy, or procedural duration.